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NEW HAVEN, Conn. – A 9-year-old boy felt a strange sensation in his right ear. He informed his doctor about Yale New Haven Children's Hospital. Three days ago he had heard a buzz in that ear.
Still, the boy did not feel any real pain and he could hear perfectly, according to a case study published Wednesday in the New England Journal of Medicine.
When asked what he did, the boy said he was playing outside at school.
Dr. Erik Waldman, co-author of the report and head of pediatric otolaryngology at the hospital, scrutinized the boy's ear and saw something unexpected: a tick implanted in the right tympanic membrane – the tympanum – where it was surrounded by inflamed tissue. .
Waldman tried to remove the tick, but the incorporated arachnid did not want to move. (Ticks are generally thought to be insects, but they are related to spiders.)
Dr. David Kasle, co-author of the report and resident in otolaryngology at Yale New Haven Hospital, said that "in any child, removing a foreign body from the ear is difficult – but especially in this case. "The tick capitula – the parts of the mouth that probe, hold and suck blood – have been" dug out, "said Kasle. Pulling the tick right away could cause pain and possibly tear the membrane.
"The eardrum is essentially part of a fairly complex lever mechanism that allows the sound to travel from the outer ear to the inner ear and through the middle ear, where there are ossicles, small bones," he said. explained Kasle. "You need this battery intact to get a good sound."
Failure to remove the tick would also have consequences, he said. In time, the boy could not hear well. Nevertheless, he did not want to "inflict more damage", including a possible perforation of the eardrum. A hole might not dull the boy, but it would "dampen" his hearing, Kasle said. Many perforations of the eardrum heal of their own, he says, but not all.
"We took her to the operating room, slept her and we were able to use some really good tools to remove the tick's head," said Kasle, who performed the surgery. delicate operation. The tick has been tested and identified as Dermacentor variabilis: a dog tick, commonly found in parts of the United States.
Kasle treated the boy with a drop of antibiotic to heal any gall. A month later, the child was fine. Its tympanic membrane was repaired and it developed neither fever nor rash.
"It's pretty unusual to have a tick that's embedded in the membrane like this," said Kasle.
The danger of ticks
Dr. Lorenza Beati, Curator of the US National Tick Collection and Professor of Biology at Georgia Southern University, agreed.
Very rarely, ticks will attach to unusual places such as the inside of the ear, wrote Beati, who was not involved in the case study, in an email. "Some ticks in Africa do, but in the United States it's a very, very unusual event, especially because an adult [dog tick] is large enough and people often discover the tick that crawls before attaching. "
In North America, dog ticks are commonly found in the eastern Rocky Mountains, but also in parts of the Pacific Northwest, Canada, and Mexico. As its name indicates, ticks of this species can be found on dogs but also on cats and humans. Eight-legged adults sometimes carry and transmit bacteria that cause Rocky Mountain spotted fever, which causes headaches, fever and rashes, as well as tularemia, causing fever and ulcers skin.
"This is not the first time that ticks have been found in unusual places," said Neeta Pardanani Connally, director of Tickborne's Transmission Disease Prevention Laboratory at Western Connecticut State University. People's eyes are another improbable home. Connally, who played no role in the study, even removed the ticks from his belly button.
Ticks tend to crawl "until they find a warm and comfortable place to attach," she explained. "It's more common to find ticks tied behind the knees, in the groin areas, under the armpits, behind the ears. Dog ticks like this one are usually associated with human heads. "
The main danger of ticks is their ability to transmit diseases. "In the United States, the most common tick disease is Lyme disease, with about 300,000 cases each year," she said.
Expert safety tips
Beati has come up with several suggestions for preventing tick bites.
"Wear appropriate clothes when you walk in the woods (long pants, shirt tucked in pants, good shoes, no flip flops!" She added that "a little DEET sprayed around your ankles, wrists, collar" can also prevent ticks from getting into your clothes and biting you.
Connally said that bathing or showering within two hours after being on the outside protects against Lyme disease. Not only does a bath or shower require you to remove what you wear – clothes that may contain one or two creeping ticks – but it will eliminate all loose ticks.
Beati warned: "Do not wait long before removing the ticks. Disinfect it after removing it if you can. Use tweezers to gently remove an attached tick from your skin, then rub the area with rubbing alcohol.
Connally recommended getting acquainted with the types of ticks that live near you and the diseases they carry. If you develop symptoms, including rashes or flu-like illness, a few days or even months after a tick bite, you should see a doctor, she said.
And do not forget the dog or the cat of the family.
"People should also treat their pets with a tick preventive product all year," she said.
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