Many of us recall as kids our parents would tuck us into bed and say, “Sleep tight. Don’t let the bed bugs bite.” It seems we have a lot more to worry about than bed bugs when we begin to fall into a deep slumber. In a video, an unidentified man who was diagnosed with a severe white maggot infestation in his ear canal is seen at the mercy of Dr. Vikram Yadav.

Yadav captures the moment he removes hundreds of maggots individually from the young man’s ear with tweezers. The maggots, which are visibly a white mass deep in his ear, were feeding off the man’s flesh to survive. The doctor believes houseflies most likely invaded the man’s ear and laid eggs while he was sleeping.

Most cases of animals in the ear canal, known as aural myiasis, are usually flying objects and cockroaches. An article published in the Otolaryngology Head and Neck Surgery claims aural myiasis is rare and occurs most often in children younger than 10 years because of their low level of personal hygiene. However, this infestation can also occur in adults, especially those who are mentally disabled. It is not clear whether Yadav’s patient suffers from any mental illness.

The maggots removed from the man’s ear canal, squirming as they're removed one by one with tweezers, are 1 centimeter long. Yadav then adds them to a plastic tube where you can see them wriggling. The doctor claims the best way to remove the maggots is “to make them suffocate so they come to the surface.” He uses ivermectin, the anti-parasitic medicine, so the new eggs didn’t hatch, and picked out the maggots manually.

Yadav leaves us with a very important tip: “If anybody sleeps, a child, an old person, and you see any houseflies there, put some cloth on their face so they don’t enter into the orifices and lay their eggs. Prevention is better.”

This case is similar to the 92-year-old grandmother in Illinois with Alzheimer’s disease, who had 57 maggots living in her left ear. Since she is unable to speak or care for herself because of the debilitating disease, Catherine McCann was not able to communicate with the staff about her discomfort. It is believed the maggots had been in the woman’s ear for up to three days.

A rule of thumb is if your ear is unusually itchy and you’re experiencing discomfort, see a doctor.