Mites in the External Auditory Canal
A 70-year-old man presented with a 2-month history of pruritus and a sense of fullness in the right ear. There was no hearing impairment, tinnitus, or otorrhea. Otoscopic examination revealed a number of mites (Panel A, arrows) and mite eggs in the right external auditory canal (see video). Extracted mites were identified as the house-dust mite Dermatophagoides pteronyssinus (Panel B, mite egg; Panel C, female mite; Panel D, male mite). Otoacariasis, the infestation of the external auditory canal by various genera of mites or ticks, is not uncommon in livestock and domestic animals but is less common in humans. House-dust mites are found in human habitations worldwide and feed on flakes of shed human skin. The patient was treated with eardrops containing triamcinolone, nystatin, neomycin, and gramicidin, and when he was seen in follow-up 2 months later, his symptoms had resolved.