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Peer-reviewedCC BYFrontiers in public health

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

  • Yongzhi Niu1
  • Wenxiu Jiang2
  • Kaixuan Chen1
  • Fei Che1
  • Xiaojun Wang1
  • Wenhuan Wang3
  • Xiaoting Wang4
  • Wenhui Pang1
4 affiliations
  1. 1Department of Otolaryngology-Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
  2. 2Department of Otolaryngology, Eye and ENT Hospital, Fudan University, Shanghai, China.
  3. 3Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
  4. 4Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Abstract

Objective

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.Methods

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.Results

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.Conclusion

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.

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Cite

BibTeXRIS
BibTeX
@article{niu2026otoacariasis,
  title = {{Otoacariasis in East China: a case series of three tick bites with diagnostic and management challenges.}},
  author = {Yongzhi Niu and Wenxiu Jiang and Kaixuan Chen and Fei Che and Xiaojun Wang and Wenhuan Wang and Xiaoting Wang and Wenhui Pang},
  journal = {Frontiers in public health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1946165},
  url = {https://europepmc.org/article/MED/42903160},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Otoacariasis in East China: a case series of three tick bites with diagnostic and management challenges.
AU  - Yongzhi Niu
AU  - Wenxiu Jiang
AU  - Kaixuan Chen
AU  - Fei Che
AU  - Xiaojun Wang
AU  - Wenhuan Wang
AU  - Xiaoting Wang
AU  - Wenhui Pang
PY  - 2026
DA  - 2026/10/06
JO  - Frontiers in public health
DO  - 10.3389/fpubh.2026.1946165
UR  - https://europepmc.org/article/MED/42903160
AB  - Objective  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.Methods  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.Results  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.Conclusion  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.
SN  - 2296-2565
ER  -