An unusual foriegn body of the ear

InduDharan Manon dharan at KB.USM.MY
Wed Jun 28 23:25:14 EST 1995


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 



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