The n e w e ng l a n d j o u r na l of m e dic i n e

images in clinical medicine

Mites in the External Auditory Canal

A B

C D

A
70-year-old man presented with a 2-month history of pruritus En-Chih Liao, Ph.D.
and a sense of fullness in the right ear. There was no hearing impairment, Taichung Veterans General Hospital
tinnitus, or otorrhea. Otoscopic examination revealed a number of mites Taichung, Taiwan
(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 Ke-Chang Chang, M.D.
(Panel B, mite egg; Panel C, female mite; Panel D, male mite). Otoacariasis, the
National Yang-Ming University Hospital
infestation of the external auditory canal by various genera of mites or ticks, is not Yilan, Taiwan
uncommon in livestock and domestic animals but is less common in humans. postdream8@hotmail.com
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.
DOI: 10.1056/NEJMicm1010983
Copyright © 2012 Massachusetts Medical Society.

n engl j med 367;14 nejm.org october 4, 2012 e19

The New England Journal of Medicine
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