J Audiol Otol.  2018 Jul;22(3):167-169. 10.7874/jao.2017.00388.

A Case of Contrast Enhanced Cystic Mass of External Ear Canal Diagnosed as Engorged Hard Tick

• Lee MY
• Jung JY

• KMID: 2418922
• DOI: http://doi.org/10.7874/jao.2017.00388

Abstract

A 58-year-old female complained earfullness and otalgia and came to the clinic. Dark gray colored cystic mass obstructing the left ear canal was observed during the endoscopic exam. Contrast enhanced CT image showed an oval shape soft tissue lesion in the mid part of the external auditory canal with a homogenous increased contrast uptake. The mass was removed under microscopic view at outpatient clinic. While dissecting the mass in the ear canal, a pod like structure was visualized. The external organism was densely adherent to the skin and turned out to be an engorged hard tick. Considering the final diagnosis, contrast uptake observed in the CT scan implicates the patient communication of blood between host and parasite. This unique image finding differs from a benign mass lesion in the ear canal was one of the differential diagnosis points for the lesion. This article is reporting the case of tick bite in the ear canal with a rare CT scan finding.

Keyword

External ear canal; Cystic mass; Tick

MeSH Terms

Ambulatory Care Facilities
Diagnosis
Diagnosis, Differential
Ear Canal*
Ear, External*
Earache
Female
Humans
Ixodidae*
Middle Aged
Parasites
Skin
Tick Bites
Ticks
Tomography, X-Ray Computed