A Small Child is Brought to the Emergency Room Acutely Agitated

A 1-year-old male in severe distress was brought to the emergency room early in the morning by his mother. The mother describes her child as normally mild mannered and happy. He woke her up in the early morning hours screaming and holding his head as if he was experiencing acute pain. She had taken his body temperature and said that it was normal. 

The child was physically examined and there was nothing outwardly abnormal other than his extremely agitated state. His temperature was taken and was found to be normal at 98.6 degrees. Auscultation examination of the chest, abdomen and bowels was normal.

Since the child was not able to verbally communicate where his exact pain was it was important to carefully observe him during the examination in hopes that his actions might provide a clue as to what and where his discomfort was originating from. The key observation noted in the examination was a periodic pulling of his right ear as he would become more agitated. 

An examination of the right ear was significant for the appearance of an object imbedded deep in the ear canal. The doctor proceeded to remove the object carefully and with some difficulty as the object seemed to resist removal. After three attempts the object was finally removed and placed in a sterile sealed cup to be sent to the laboratory for identification. A photo of the object removed was identified as an arthropod by the Microbiology Lab and is shown below. 

Photo of arthropod removed from inner ear of small child

Upon removal of the arthropod the child immediately was relieved of any pain and slowly went to sleep after being fed. The patient was discharged, with instructions provided to the mother, to have her schedule a follow-up with the child’s pediatrician.

Answer the following questions:

  1. What is the identification of the arthropod retrieved?
  2. What are some key identifying characteristics of this arthropod?
  3. What developmental form of the arthropod are we seeing in the image?
  4. Is this arthropod considered a vector of disease(s)?


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