Foreign bodies in external auditory canal (EAC) are one of the most common problem encountered in the emergency or outpatient department by otorhinolaryngologist. Patients present to the clinic with different type foreign bodies, ranging from small beads to living insects. They could lead to various complications, such as abrasion of EAC, otitis externa and tympanic membrane perforation. Therefore, it is important to identify and remove the foreign body while minimizing the damage of the surrounding structure. Here we present a case of foreign body found in EAC, initially misdiagnosed as hemorrhagic mass, which was later identified as Haemaphysalis longicornis Neumann, known as Asian long horned tick during the operation process. Reporting this case, we want to discuss about the importance of identifying the type of foreign bodies and about the tick-borne disease we have to consider when encounter the insects in EAC.
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