Infestation of Mites in External Auditory Canal

Abstract

A 48-year-old man, previously healthy, presented with a 12-day history of intense pruritus in his right external auditory canal (EAC) that was progressing to a sensation of something moving inside it. Otoscopy showed discharge, animated foreign bodies, and an erythematous ear canal with debris and a diffuse superficial impregnation of some cystic material (figure 1). The tympanic membrane was not perforated.When viewed under light microscopy, the strange animated bodies in the EAC were identified as mites. Samples were collected and sent for analysis to the Entomology Department of Londrina State University, and under light microscopy after slide preparation, they were identified as Dermatophagoides mites.The patient was treated with oral ivermectin, successive ear irrigation, and deltamethrin (a synthetic pyrethroid used as a pesticide) ear drops.

The first case of human otoacariasis in Cyprus

“…The initial primary treatment for otoacariasis infestations usually involves the physical removal of the infesting organisms either by direct removal or flushing (Ueda et al, 2017;Cho et al, 1999), followed by some medicated treatments of the resulting symptoms such as inflammation and itching. Often it is not possible to physically remove all individuals and its various life stages (adults, nymphs, and eggs) of the infesting organism during the initial treatment.…”

“…Often it is not possible to physically remove all individuals and its various life stages (adults, nymphs, and eggs) of the infesting organism during the initial treatment. Therefore, continual daily auricular irrigation or application of pesticide treatments are required over the intervening days/weeks to be sure of the complete eradication of the organisms in question (Ueda et al, 2017). In this case, we used daily applications of a vinegar solution (dilute acetic acid) for auricular irrigation.…”

“…However, it is less commonly recorded in humans (Al-Arfaj et al, 2007;Dilrukshi et al, 2004). Most previous cases of human otoacariasis are case reports, with the more common infestations being parasitic ticks (Dilrukshi et al, 2004;Cakabay et al, 2016) and only a relatively minor number related to mite infestations (Dilrukshi et al, 2004;Alazzawi et al, 2016;Ueda et al, 2017). Pyroglyphidae is a family of non-parasitic dust mites of which the genus Dermatophagoides contains species of house dust mites (HDM).…”

“…As a result of otoacariasis, mites can be present in different life stages such as egg, nymph, and adult (Ueda et al, 2017). The most common symptoms of otoacariasis are usually pruritis, otalgia, blockage of the ear canal.…”

“…In addition to such treatments, the physical removal of the infecting organism is paramount. This can be achieved through flushing the ear canal, ear drops, and the direct removal of the organism and its various life-stages (Ueda et al, 2017;Abi-Aki et al, 2017).…”