To Whomsoever it may concern,
This is to bring your attention to a recent problem which we encountered
in the city of Kota Bharu in Malaysia. We in the Department of ENT of the
University Sains Malaysia were faced with an unusual foreign body of the
ear in some of our patients. Few of them presented with complaints of an
insect in the ear, while others presented with various comlaints like
pain, bleeding and vertigo. On examination we found a red haemorrhagic
bulla which on removal was found to be the blood filled bloated body of a
tropical cattle tick which was identified as Boopilus microplus. Removal
of this tick immediately relieved the complaints, though the ear drum is
partially damaged in most of the cases. One of the most recent cases
presented with a history of insect in the right ear and sudden onset of
right lower motor neuron paralysis of the seventh cranial nerve(facial
palsy) of three days duration. On examination the finding was a "typical
haemorrhagic bulla". Due to the history of the insect, we tried removal
and it was found to be the cattle tick mentioned above. The ear drum was
torn at the site of attachment of the tick, but the middle ear as could be
seen through the tear was clean and dry. Surprisingly within 48 hours the
facial palsy recovered! Is there anybody who know of any neurotoxins or
enzymes in ticks that can produce neurological manifestations like this in
animals or man? Is it possible to analyse this tick for any toxin that
produced facial palsy? I would much appreciate a reply. Thank you,
Dr.R.Indudharan,
Lecturer, Department of Otorhinolaryngology,
PPSP, University Sains Malaysia,
16150 Kubang Kerian, Kelantan, MALAYSIA
Fax. 09-7653370
E-mail. dharan at kb.usm.my
