Case Report Aural Myiasis, a Rare Cause of Earache Ibrahim Al Jabr Department of Otolaryngology and Head and Neck Surgery, College of Medicine, King Faisal University, P.O. Box 66678, Al-Ahsa 31982, Saudi Arabia Correspondence should be addressed to Ibrahim Al Jabr; ibrahimkaj@gmail.com Received 24 June 2015; Revised 7 August 2015; Accepted 9 August 2015 Academic Editor: Yorihisa Orita Copyright © 2015 Ibrahim Al Jabr. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Myiasis of the ear is an infestation of the ear by maggots (the larval stage of lies). In the literature, there are only few cases reported about aural myiasis. It is more common to occur in tropical regions, where humidity and warm weather provide a good environment for this infestation. In this paper, a 12-year-old boy is reported to have unilateral earache for 3-day duration. Examination of the painful ear showed a tympanic membrane perforation with larvae (maggots) in the middle ear. hey were removed by using a forceps and gentle irrigation of ear to expel any remnant. Further management included assessment of hearing, computed tomography (CT) scan, and outpatient follow-up. 1. Introduction Myiasis is a common infestation among mammals. In humans, it is seen more in rural areas where people are in more direct contact with animals [1]. he disease occurs when the female ly lays eggs, which shortly will cause clinical manifestations that are related to the body site involved [2]. In the ield of otolaryngology, it may afect the ears, nose and paranasal sinuses, nasopharynx, oral cavity, and skin of the head and neck region. Risk factors for myiasis in humans are chronic suppurative otitis media, low socioeconomic status, swimming in stagnant water, and diabetes mellitus [3]. Other possible predisposing factors include neglected children, old age, mental retardation, and poor personal hygiene. 2. Case Report A 12-year-old boy, previously healthy, presented to the emer- gency department complaining of right earache for 3-day duration. his ear pain started suddenly and the patient has described it as being mild to moderate in severity. he patient is complaining also of minor decrease in hearing and itching in the ear canal. here was no history of purulent, bloody, or clear ear discharge, tinnitus, vertigo, or facial weakness. here was no history suggestive of intracranial involvement. Social history showed that the patient lives in dessert with his family, in a Bedouin culture. General clinical examination, vital signs, and exami- nation of nose, throat, let ear, head, and neck were all within normal. Inspection of the right ear externally was unremarkable; there is mild to moderate tenderness with pressure over the tragus or by gentle movement of the auricle. Examination by otoscope and microscope showed mild edema and erythema of the external auditory canal, a clean central perforation of the tympanic membrane of about 5 mm (Figure 1), and 2 larvae in the middle ear, protruding through the perforation. A crocodile forceps was used to remove these 2 larvae (Figure 2). Irrigation of the ear with sterile water was done, ater which 4 more larvae which were in the attic region and not visible showed up and came out to the external auditory canal through the perforation and were removed. Further carful inspection and irrigation were made but did not show any more remnants. he removed larvae were identiied by microbiologist to belong to the Sarcophagidae family, genus Wohlfahrtia, and species Wohlfahrtia magniica. It is also known as spotted lesh ly or Wohlfahrt’s wound myiasis ly. he larvae are cylindrical in shape with lattened ventral surface, 8 to 12 mm in length, white in color with grayish tinge. Spines are separating the body segments of the larvae. hey have the characteristic sarcophagid posterior end, with the posterior spiracles set in a cavity. Hindawi Publishing Corporation Case Reports in Otolaryngology Volume 2015, Article ID 219529, 3 pages http://dx.doi.org/10.1155/2015/219529