Doctors found a man's ear infested with grim flesh-eating maggots after he went to hospital complaining of a five-day earache.
The unnamed 64-year-old's ear was full with "numerous mobile larvae" blocking the ear canal.
He went to Hospital Pedro Hispano in Matosinhos, Portugal, after experiencing pain, itching and bleeding from the ear for nearly a week.
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The gruesome case had been documented in a paper published by the The New England Journal of Medicine.
Doctors used forceps to pick out the maggots, finding that a part of his eardrum had actually been perforated by the larvae.
The ear was then cleaned with irrigating water and treated with antibiotic ear drops, boric acid solution and oral antibiotics.
Catarina Rato, one of the doctors, told Newsweek: "The [characteristics] of the larvae, cylindrical, segmented, white yellow-colored body… were compatible with the Cochliomyia hominivorax species."
Cochliomyia hominivorax, more commonly known as the New World screw-worm fly, is a species of parasitic fly known for how its larvae eat the living tissue of warm-blooded animals.
Females can lay between 250-500 eggs in exposed living flesh, often targeting wounds in animals.
The maggots then hatch and burrow into the surrounding flesh, feeding on it as they do so.
Horrifyingly, the maggots will burrow deeper if the wound is disturbed, hence the name "screw-worm". This can be so extreme that the host animal dies.
After around three to seven days the larvae will drop to the ground and pupate, reaching adulthood around one week later.
The entire lifecycle of a screw-worm fly lasts roughly 20 days, during which time a female can lay up to 3,000 eggs.
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