A rare presentation of complicated acute otitis media: a case report

Abstract

Author(s): Abdullah Musleh, Hussain Almohiy

Extracranial complications of Acute Otitis Media (AOM) are uncommon but usually associated with severe adverse outcomes. Here we report the case of an 8-year-old Saudi boy who presented with left-sided facial oedema and proptosis, with ear pain and fever. Clinically, the patient had severe oedema in his left eye, confirmed by redness, and otitis media diagnosed by tympanometry. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed a left mastoiditis and middle-ear collection of fluid, associated with severe soft-tissue oedema involving the orbit, zygomatic arch and temporoparietal region, without abscess formation. The diagnosis was AOM complicated by mastoiditis and soft-tissue oedema, and left eye proptosis. Considering the bodyweight of the patient, intravenous ceftriaxone and clindamycin were administered, followed by direct improvement. The oedema subsided 2 weeks later with the resolution of symptoms and, ultimately, complete healing. Clinicians should apply caution with complicated or refractory cases of AOM because of the potential lethal outcomes.

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