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1 病例介绍 患者男,54岁,农民。1992年7月12日,突然1只苍蝇飞入左耳内,自觉有嗡叫感,1小时后左耳内闷胀感,持续1个月,剧痛2天,继而出现耳呜,来医院就诊。就诊前当地乡村赤脚医生给以去痛片2片3/日不见好转。门诊查体:体温37℃,血压17.5/11.3KPa。实验室检查:WBC12.0×10.9/L,v0.76,10.18,W0.6。X线报告未见明显骨质破坏。神志清楚,痛苦表情,自动体位,发育正常,营养中等,全身皮肤无破损,心肺正常。鼻咽喉无异常,双外耳道无畸形,耳前无瘘管。额镜检查发现左外耳道有条状白色物阻塞,可见到条状物蠕动。在额镜下用枪状镊取出6条长约10～12毫米,直径1.2～1.8毫米,两端稍扁,能蠕动的小虫。当地昆虫研究人员辨认为蛐虫。
1 case description Male patient, 54 years old, farmer. July 12, 1992, suddenly a fly flies into the left ear, consciously with a sense of hum, 1 hour after the left ear muffled, sustained 1 month, severe pain 2 days, followed by the emergence of tinnitus, to the hospital Visit. Local barefoot doctor before going to the hospital to give painkillers 2 3 / day did not improve. Outpatient examination: body temperature 37 ℃, blood pressure 17.5 / 11.3KPa. Laboratory tests: WBC12.0 × 10.9 / L, v0.76, 10.18, W0.6. X-ray report no obvious bone destruction. Conscious, painful facial expressions, automatic position, normal development, moderate nutrition, body skin without damage, normal heart and lung. No abnormal nasopharyngeal throat, no abnormalities in both external auditory meatus, no fistula before ear. The frontal mirror examination revealed a white obstruction of the left external auditory meatus, showing a strip of motility. Under the frontal mirror with a gun-like tweezers removed six about 10 to 12 mm in diameter 1.2 to 1.8 mm, slightly flat at both ends, can crawl insects. Local insect researchers identified pinworms.