Aural Myiasis

I have Meniere’s disease so when the ear pain and tinnitus started I thought I was just having a flare up. The buzzing noise was new but I assumed it was just the beginning of hearing loss associated with Meniere’s disease. My ear felt full, like it was underwater; but, again, that was normal. My ear itched like something was crawling in it; but, while not the norm, I didn’t think much about it. When the blood oozed out of my ear I realized this is not my Meniere’s disease acting up. This was something new. The pressure did not feel like it could have ruptured my eardrum. I could still hear; so, it could not have been that bad. I called my ENT and made an emergency appointment anyway.

An hour later, I was sitting on the exam table. The doctor put the otoscope in and looked. She gagged; and, dropping the light, quickly backed away. Stammering she said, “Let me get someone,” and rushed out the door.

I sat there stunned. What had she seen? What could be so bad as to cause her to gag?

The door opened. One of the other doctors I had seen around the office entered, and said, “I need you to remain calm. This is something we can hopefully easily fix.” He tried to sound soothing. Do doctors not know that saying the word “calm” can cause people to have the opposite reaction? “I will be taking over as the previous doctor is unable to handle your current infestation.”

“Infestation?” I asked, with the buzzing I was hopeful I had heard him incorrectly.

“Yes,” he said with a sigh. “Now the procedure is simple…

“Infestation of what?” I screeched.

“Please, allow me to explain,” he continued robotically.

I took a deep breath and again, softly, asked, “Infestation of what?”

“Are you sure you want to know, ma’am? I can take care of this rare condition without giving you the details. It is unlikely that there will be a repeat infestation so long as it is properly taken care of.”

“Infestation of what?” I demanded.

“Maggots.”

I started shaking, “Get them out now,” I whined. I felt tears running down my cheeks. The itching I had been feeling since yesterday must have been them moving around in my ear… moving in my head. “Get them out,” I screamed.

‘I will,” he said in his calm, robotic voice. He pulled open a drawer and pulled out a light blue plastic cloth like dentists use. Draping it over my shoulder he continued, “I will not stop until they have all been removed. Please sit still so I can look in your ear.” He put the otoscope into my ear and looked. Then he went to a drawer and pulled out a petri dish and a pair of tweezers. “I am going to take these forceps and remove the ones in your outer ear. I will place them into the petri dish for testing.”

“Testing for what?”

“For classification mostly,” he said as he put the tweezers in and pulled one out. He lifted the lid off, placed the small, squirming maggot inside, and covered it. Then he went back into my ear for another.

The door opened and a male nurse came into the room backwards, “Doctor Smith said you would need saline solution for an ear irrigation.” The nurse was carrying a tray with syringe, one of those kidney-shaped bowls that was empty, another bowl filled with a clear liquid, and a lot of gauze pads.

“Yes that will be the next step,” The doctor said pulling a third maggot from my ear. “You can just put it next to the sink. Make sure they have her scheduled for the CT,” he continued going back in with the tweezers again.

“I will come back when they are ready for her,” The nurse murmured, putting his hand over his mouth and rushing out the door.

“Seems like you have the strongest stomach here,” I said trying to distract myself from my own nauseousness. 

“I have done this once before,” he stated simply. “That’s the last one I see,” he advised taking the petri dish to the counter. “Now I have to irrigate,” he said with his back to me. Walking back with the two bowls from the tray, the syringe in the empty one, he continued, “It does not seem like they passed through the ear membrane.”

 “Can you hold this?” he asked, handing me the bowl of liquid.

“Sure,” I said taking it with shaking hands.

“Just sit still,” he said balancing the curved bowl on my shoulder against the side of my face under my ear. “I am going to take some of the saline solution from the cup with this syringe and then just spray it in your ear,” he said filling the syringe. “It will dribble out and into the bowl on your shoulder. It will feel odd but not painful.”

As he began, there was a knock on the door. “Come in,” he said while still putting liquid in my ear.

An elderly woman came in and said, “I am supposed to take her for a CT scan doctor.”

“Give me a few moments to finish irrigating her. Can you assist by using the gauze pads to wipe beneath her ear?”

“Of course,” she said picking up the gauze from the tray next to the petri dish. She approached and with a friendly smile began wiping the liquid from below my earlobe.

The doctor refilled the syringe four times before he was satisfied with the cleaning.  He explained, “Once they do the CT scan, I will review the results.  We will then see where we have to go from there. It will take an hour or so.  During your wait I don’t want you to eat or drink anything in case of the worst case scenario. Do you have something to occupy your time?”

“I have my phone,” I answered as he took the half-empty bowl from my hands.

“I will see you again soon,” he said handing me off to the elderly woman.