Fly Larva Crawls Inside Woman's Ear
A woman's ear pain was the result of a fruit fly larva moving in her ear. Above, an image of the larva.
Credit: The New England Journal of Medicine ©2014.

A woman in Taiwan had an unusual cause of her ear pain: a fruit fly larva was wriggling around inside her ear canal.

The 48-year old woman went to the emergency room after experiencing severe ear pain for a day, according to a new report of the case. Doctors removed the woman's hearing aid, and saw bloody fluid in her ear.

An exam revealed a fruit fly larva moving around in her ear canal, and the skin close to her eardrum was eroded, according to the doctors at Tri-Service General Hospital, in Taipei.

Doctors removed the larva, and the woman received topical antibiotics. Her ear pain went away immediately, and two weeks later, her ear canal had healed, the report said. [Video: Fly Larva Crawls in Woman's Ear]

Dr. Richard Nelson, an emergency medicine physician at Ohio State University Wexner Medical Center, who was not involved in the woman's case, said he has seen several types of insects in human ears, but not fruit fly larva.

In the emergency department, such critters are typically removed with forceps, or with irrigation using water or saline, Nelson said. In some cases, doctors use mineral oil or lidocaine gel to reduce the patient's pain as well as to suffocate the insect, Nelson said.

As a live insect crawls down the ear canal, it may touch the ear drum and cause pain, but usually does not perforate the ear drum, Nelson said. Still, infections are a concern when insects enter the ear, Nelson said.

Cockroaches are the most common insect Nelson has seen in patient's ears — they crawl into the ear at night. "They tend to run toward small dark places, which fits the description of the ear," Nelson said.

Over the years, Nelson has learned not to tell patients that they have an insect in their ear until it's removed. "Some people just really get freaked out if you tell them they’ve got something live in their ear," which makes it difficult to remove, Nelson said.

Infections with fly larva are known as myiasis, and are most common in tropical and subtropical areas, according to the Centers for Disease Control and Prevention.
