An unusual foriegn body of the ear

James Watson jwatson at aries.dpi.tas.gov.au
Sun Jul 2 22:23:36 EST 1995


In article <Pine.3.89.9506291107.A16665-0100000 at kb.usm.my>,
   dharan at KB.USM.MY (InduDharan Manon) wrote:
>To Whomsoever it may concern,
>This is to bring your attention to a recent problem which we encountered 
>in the city of Kota Bharu in Malaysia. We in the Department of ENT of the 
>University Sains Malaysia were faced with an unusual foreign body of the 
>ear in some of our patients. Few of them presented with complaints of an 
>insect in the ear, while others presented with various comlaints like 
>pain, bleeding and vertigo. On examination we found a red haemorrhagic 
>bulla which on removal was found to be the blood filled bloated body of a 
>tropical cattle tick which was identified as Boopilus microplus. Removal 
>of this tick immediately relieved the complaints, though the ear drum is 
>partially damaged in most of the cases. One of the most recent cases 
>presented with a history of insect in the  right ear and sudden onset of 
>right lower motor neuron paralysis of the seventh cranial nerve(facial 
>palsy) of three days duration. On examination the finding was a "typical 
>haemorrhagic bulla". Due to the history of the insect, we tried removal 
>and it was found to be the cattle tick mentioned above. The ear drum was 
>torn at the site of attachment of the tick, but the middle ear as could be 
>seen through the tear was clean and dry. Surprisingly within 48 hours the 
>facial palsy recovered! Is there anybody who know of any neurotoxins or 
>enzymes in ticks that can produce neurological manifestations like this in 
>animals or man? Is it possible to analyse this tick for any toxin that 
>produced facial palsy? I would much appreciate a reply. Thank you,
>Dr.R.Indudharan,
>Lecturer, Department of Otorhinolaryngology,
>PPSP, University Sains Malaysia,
>16150 Kubang Kerian, Kelantan, MALAYSIA
>			Fax. 09-7653370
>			E-mail. dharan at kb.usm.my 

While some ticks certainly do produce neurotoxins, Boophilus sp, as far as I 
know, are not usually considered to do so. In any case, the symptoms are 
usually a generalised ascending flaccid paralysis rather than a localised 
problem.

I wonder, given the proximity of the facial nerve to the point of attachment, 
if local inflammation and swelling might account for the observed palsy?

Just a thought,

James Watson
Veterinary Clinical Pathologist.



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