A Rare Case of Hiccups

To the Editor: Hiccups can have a variety of causes,^1,2 but food or alcohol ingestion is the most common. We report an unusual cause of hiccups in a 19-year-old woman. The patient presented with persistent hiccups that had started two hours earlier, after the intrusion of an unidentified insect into her left ear. The hiccups occurred three to five times per minute and were accompanied by an unpleasant itching sensation in the ear. Physical examination was normal except in the left external auditory canal, where a small ant was crawling on the tympanic membrane. The ant was irrigated from the. No extract is available for articles shorter than 400 words.