A Case of Contrast Enhanced Cystic Mass of External Ear Canal Diagnosed as Engorged Hard Tick

Abstract

A 58-year-old female complained earfullness and otalgia and came to the clinic. Dark gray colored cystic mass obstructing the left ear canal was observed during the endoscopic exam. Contrast enhanced CT image showed an oval shape soft tissue lesion in the mid part of the external auditory canal with a homogenous increased contrast uptake. The mass was removed under microscopic view at outpatient clinic. While dissecting the mass in the ear canal, a pod like structure was visualized. The external organism was densely adherent to the skin and turned out to be an engorged hard tick. Considering the final diagnosis, contrast uptake observed in the CT scan implicates the patient communication of blood between host and parasite. This unique image finding differs from a benign mass lesion in the ear canal was one of the differential diagnosis points for the lesion. This article is reporting the case of tick bite in the ear canal with a rare CT scan finding.

Tick in both external auditory canals: An extremely rare case report

“…The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues. On the other hand, bites are mostly seen in the people working at slaughterhouses, living in rural areas, and dealing with livestock (4,5).…”