Clinical presentation
We present a 14 year old grade 7 female patient who visited our hospital
with a complaint of right ear pain of two years duration. She had been
complaining of intermittent type of ear ache over the past eight years
for which she visited a number of health facilities. The pain worsened
over the past two years which led her to get evaluated at our
institution. In addition, she complains headache, itching, roaring sound
in her ear, tinnitus, loss of sleep, difficulty attending her school
lesson, and minimal hearing loss. She tried to get rid of the discomfort
by inserting a cotton tip into her ear and applying the Valsalva
maneuver (fig.1). She observed plenty of worms coming out of
her ear after being triggered by the cotton tip and following which she
felt relief. Recently, she saw adult flies coming out of her right ear
and flew away(fig.2 ). Otherwise, she has no fever, body
weakness and change in behavior. She is the 3rd child
for her families and has four brothers and three sisters. She takes
shower once a week. She has no comorbid illnesses like diabetes mellitus
and neuropathy.