A 63-year-old male veteran presents to the VA with concerns for painless decreased hearing in one ear.
When the patient was examined, the pathology shown in the image was unclear. ENT was e-consulted who thought it might be a polyp. Exploring the lesion was considered but quickly discarded.
The veteran returned to the VA about a week later for a different issue. He reported that a fully engorged tick had walked out of his ear.
On re-evaluation of the image, it clearly shows congealed blood adjacent to the “polyp” consistent with a tick attachment.
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