Photo Quiz: An ear-resistible occupant in a 73-year-old patient

PHOTO QUIZ

A 73-year-old man from Texas presented to his primary care provider with a chief complaint of fullness in the left ear for 1 week. The patient did not endorse any further complaints. Upon examination, the primary care provider noticed something deep in the left ear canal. Using forceps, the provider removed a single organism from the left ear canal (Fig. 1). Further medical examination revealed an additional similar organism in the right ear canal (Fig. 1).

Fig 1.

Objects removed from the ear of the patient. Objects measured 0.9 × 0.55 cm on average.

After removal of the organisms, the primary care provider obtained a more thorough history from the patient. The patient resided in a rural area of Texas and did not report any recent travel or exposure except for frequent walks in the woods with the family’s dogs. Additionally, the patient noted that 1 month prior to his visit, he had removed a similar organism from the ear of his spouse. The organisms were submitted to a reference laboratory for parasite identification.