Adult Popillia japonica as an Otorhinolaryngologic Invasive Foreign Body in a Rural Area

Lindsey Schwanke,Derek Chen,Christine M Lomiguen,Justin Chin

doi:10.7759/cureus.12046

Abstract

Otorhinolaryngologic foreign bodies may be encountered in-office visits, the emergency department, and speciality consultations. These include food, toys, and other small items, are present in pediatric patients. Because patients may be asymptomatic and the insertion of the foreign body not observed, obtaining medical care may be delayed. Conversely, insects as foreign bodies, especially in the external ear canal, can cause a patient significant pain and distress, directing the patient to seek immediate care. Here, we present a case of an adult Japanese beetle (Popillia japonica) as a foreign body in the ear of a 14-year-old female. A review of otorhinolaryngologic foreign bodies is also discussed, with particular attention to the ear and rural location. This case highlights the potential for agricultural insects to act as invasive foreign bodies, especially in areas where they are known to be endemic pests and the consequences of delayed treatment.

Highlights

Popillia japonica, more commonly known as the Japanese beetle, was discovered in the United States in the early 1900s [1]
We present a case of an adult Japanese beetle (Popillia japonica) as a foreign body in the ear of a 14-year-old female
The Japanese beetle is most predominantly found in the Midwest and East Coast of the United States, with only nine states considered pest-free [2,3]

Summary

Introduction

More commonly known as the Japanese beetle, was discovered in the United States in the early 1900s [1]. Ranging from asymptomatic irritation to pain and possible hearing loss, a patient presentation can vary depending on the type and size of an insect, location in the EAC, and duration of exposure [8,9]. Direct visualization and prompt removal are critical in relieving the physical and emotional discomforts of the foreign body as well as preventing future sequelae [10]. This case report focuses on the presence of a foreign insect body, the Japanese beetle, in the ear canal of a 14year-old female and reviews treatment considerations and challenges in rural settings. Physical exam revealed a normal left ear, with clear EAC and mobile tympanic membrane on otoscopic examination. Initial audiological evaluation revealed mild conductive hearing loss; a repeat audiogram one week following the incident was normal

Discussion

Conclusions

Disclosures

Kistner-Thomas EJ