Otoacariasis in East China: a case series of three tick bites with diagnostic and management challenges.

Authors

Yongzhi Niu, Wenxiu Jiang, Kaixuan Chen, Fei Che, Xiaojun Wang, Wenhuan Wang, Xiaoting Wang, Wenhui Pang

Published in

Frontiers in public health. Volume 14. Pages 1946165. Epub Oct 06, 2026.

Abstract

Tick bites in the external auditory canal are rare but can pose diagnostic and management challenges in primary care settings. This case series aims to highlight diagnostic challenges and public health implications of otoacariasis in East China.
We retrospectively reviewed three cases of tick bites that initially posed diagnostic and management challenges at primary hospitals in Qingdao, Jinan, and Shanghai. Clinical data, including presentation, initial diagnostic assessment, treatment, and follow-up, were extracted from electronic medical records.
Case 1: a 70-year-old female with an engorged tick abdomen mistaken for the tympanic membrane. Case 2: a 3-year-old girl with retained tick mouthparts after forceful removal. Case 3: a 5-year-old girl with a tick on the tympanic membrane misidentified as a common insect. Key diagnostic clues included tick morphology, dark red feces, and leg movement. Topical 2% lidocaine effectively immobilized ticks for atraumatic extraction.
These cases highlight a diagnostic and management gap in primary care settings in East China, underscoring the need for enhanced physician education and public awareness as a key public health strategy to promote early recognition and improve patient outcomes in the region.

PMID:
42903160
Bibliographic data and abstract were imported from PubMed on 22 Oct 2026.

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