“The patient screamed,” Tengchin Wang, director of the otolaryngology department at Show Chwan Memorial Hospital, said in a statement to The Washington Post.

The picture showed a tiny spider scurrying inside her left ear next to an exoskeleton it had shed. The doctor also shot a video, which became the centerpiece of a recent case study in the New England Journal of Medicine — and nightmare fuel for arachnophobes everywhere.

After awakening to the rustling, the woman at first tried to wait out the problem, according to the journal article. But over the next four days, the issue produced an incessant array of noises — beating, clicking and more rustling. The woman suffered insomnia as a result, and after four days of torment, she finally went to a clinic, where a doctor, upon hearing her symptoms, suspected an insect had made its way into her ear canal.

Not quite, but not far off. The doctor used his otoscope to peer into her left ear and saw the spider — an arachnid, not an insect — and its exoskeleton, Wang said in an email. He took a photograph and showed it to the woman, who was shocked.

Wang then used a suction tube to remove the spider, which was about two millimeters wide. Once he did, the woman’s symptoms abated, and she went home.

Wang said he believes the spider was a hasarius adansoni, which is more commonly known as an Adanson’s House Jumping Spider and described as an “inquisitive and audacious cosmopolitan species” found in warmer climates around the world.

Neelima Tummala, an assistant professor of surgery at the George Washington Medical Faculty Associates, said she wasn’t shocked by the news from the New England Journal of Medicine. She has found about a half-dozen bugs in patients’ ears in the five years that she has been an ear, nose and throat specialist. Her peers have all found them, too, she said.

It’s not common, “but it’s definitely not unheard of,” she added.

Research suggests that insects make up 14 to 18 percent of all foreign bodies found in ear canals.

But Tummala has never come across a spider in the thousands of ears she has examined. Most of the bugs she has run into are flies. She once discovered a small bee that had flown into a patient’s ear while they were driving. By the time Tummala got to it, the bee had died and was easy to remove. The last bug she came across was a fly that had flown into her patient’s ear and laid eggs.

“There were maggots in the ear,” she said.

That caused an infection, but once Tummala treated it, the patient was fine.

Anyone who thinks a bug might have made its way into their ear should see an ear, nose and throat specialist, or if that’s not possible, their general practitioner, she said. Tummala cautioned against sticking something like a cotton swab into the ear or trying to flush out a foreign object with drops because doing so can puncture the eardrum.

Although admittedly gross, removing an insect or even an arachnid from an ear canal is fairly easy once you get into a specialist’s office, she said. The most severe injury she’s seen from a bug was an outer ear infection.

“My advice,” she said, “is don’t freak out.”