Smithsonian.com

The New England Journal of Medicine recently posted this creepy video of ear mites crawling around in some poor 70-year-old man’s ear. The Taiwanese resident complained of “a sense of fullness in the right ear” that had been plaguing him for two months, so doctors performed an otoscopic examination. Their probing revealed ”a number of mites and mite eggs in the right external auditory canal”—a whole colony breeding, feasting and crawling all over each other within the man’s ear.

The species turned out to be house-dust mites, and doctors immediately treated the patient with eardrops containing an antifungal agent, an antibacterial agent, an anti-inflammatory medicine and an anti-mite medication. Two months after treatment, the patient reported that his symptoms had completed resolved, and doctors confirmed that the mites were purged.

House-dust mites are found in human homes worldwide and feed on flakes of shedded human skin. Luckily, though, having mites in one’s ear, a condition formally called otoacariasis, is pretty rare, reports Fox News. On the other hand, cases of cockroaches crawling into and becoming stuck in ear canals are all too common. Dr. Ian Storper, director of otology at the New York Head & Neck Institute at Lenox Hill Hospital in New York, explained the scenario to Fox:

Most of the time, the cockroach is dead inside the ear canal when the patient comes in — the difficulty that insects have in walking backward may account for their inability to get out. If it’s alive, the patient is likely to report hearing a buzzing sound, along with their pain, he said.

“It’s very important to pull out the whole thing,” Storper said. Sometimes, he said, a bug’s legs may get stuck or fall apart, leaving leggy bits behind. “If you leave legs, you can get a bacterial infection. They’re dirty, they’ve been crawling everywhere,” he said.

Given those two choices, a colony of mites may actually be the preferable, less horrific scenario.

More from Smithsonian.com:

At the ‘Mayo Clinic for Animals,’ the Extraordinary is Routine 
Top 10 Real-Life Body Snatchers