Figure 2: A picture showing an adult fly being removed with a cotton
tip.
On physical examination, vital signs were Blood pressure=100/60, pulse
rate=82 beats per minute, respiratory rate=16, temperature=36.5 degree
centigrade, and saturation 96% off oxygen. On HEENT examination, the
conjunctiva was hyperemic and the sclera non-icteric. Otoscopic
examination revealed adult flies embedded in the right ear. The tympanic
membrane was not visualized. The left ear is normal except for certain
waxes on the wall of the external auditory canal. The Rinne test for the
right ear is negative because the patient feels the vibration of the
tuning fork while it was put on the mastoid process. There were no
pertinent positive findings in the remaining systems.
Laboratory investigations were done to assess for comorbidities and risk
factors. On complete blood count, white blood cells=5000,
neutrophil=55%, hemoglobin=15gm/dl, and platelet=210000. Random blood
sugar was 120mg/dl, and HIV test=non-reactive.
After written informed consent was taken the ear was irrigated with
normal saline. There were about four adult flies that came out of the
ear while flushing with intravenous fluid (fig.3).