Middle Ear Actinomycosis

Gil Coutinho; Jorge Spratley; Inês Saldanha; Cristina Castro; Jorge Pinheiro; Margarida Santos

doi:10.1055/s-0038-1645866

Journal of Pediatric Infectious Diseases, Table of Contents

J Pediatr Infect Dis 2020; 15(03): 144-147
DOI: 10.1055/s-0038-1645866

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Middle Ear Actinomycosis

Authors

Gil Coutinho

¹Department of Otorhinolaryngology, São João Hospital, Porto, Portugal

²Otorhinolaryngology Unit, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
Jorge Spratley

¹Department of Otorhinolaryngology, São João Hospital, Porto, Portugal

²Otorhinolaryngology Unit, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal

³Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
Inês Saldanha

¹Department of Otorhinolaryngology, São João Hospital, Porto, Portugal

²Otorhinolaryngology Unit, Department of Surgery and Physiology, University of Porto Medical School, Porto, Portugal
Cristina Castro

⁴Department of Pediatrics, São João Hospital, Porto, Portugal
Jorge Pinheiro

⁵Department of Pathology, São João Hospital, Porto, Portugal
Margarida Santos

¹Department of Otorhinolaryngology, São João Hospital, Porto, Portugal

Abstract

Middle ear actinomycosis is an atypical and exceedingly rare anaerobic infection. The authors report a case of a 7-year-old girl with persistent right side otalgia, conductive hearing loss, and headache. Otoscopic findings included a thickened, intact, and bulging tympanic membrane. Computed tomography imaging revealed soft tissue density filling the middle ear with areas of bone erosion. Typical sulfur granules were found on surgical exploration. Actinomycosis was diagnosed by histopathological examination. Penicillin was prescribed for 5 weeks followed by oral amoxicillin for 6 months. Recovery was uneventful and with a 2-year follow-up, no recurrence or complications were observed.

Keywords

otitis media - actinomycosis - sulfur granules

Full Text

References

References
1 Leek JH. Actinomycosis of the tympanomastoid. Laryngoscope 1974; 84 (02) 290-301
2 Kullar PJ, Yates P. Actinomycosis of the middle ear. J Laryngol Otol 2013; 127 (07) 712-715
3 Foster SV, Demmler GJ, Hawkins EP, Tillman JP. Pediatric cervicofacial actinomycosis. South Med J 1993; 86 (10) 1147-1150
4 Lerner PI. Susceptibility of pathogenic actinomycetes to antimicrobial compounds. Antimicrob Agents Chemother 1974; 5 (03) 302-309
5 Ajal M, Turner J, Fagan P, Walker P. Actinomycosis oto-mastoiditis. J Laryngol Otol 1997; 111 (11) 1069-1071
6 Kakuta R, Hidaka H, Yano H. , et al. Identification of Actinomyces meyeri actinomycosis in middle ear and mastoid by 16S rRNA analysis. J Med Microbiol 2013; 62 (Pt 8): 1245-1248
7 Gazzano E, Chanteret C, Duvillard C, Folia M, Romanet P. A case of actinomycosis of the middle ear and a review of the literature. Int J Ped Otol Extra 2010; 5: 70-73
8 Lezcano C, Simons JP, Colman KL, Cohen MS, Lin PL, Reyes-Múgica M. Actinomycotic mastoiditis complicated by sigmoid sinus thrombosis and labyrinthine fistula. Pediatr Dev Pathol 2014; 17 (06) 478-481
9 Oukessou Y, Ait Elkerdoudi M, Abada RL, Mahtar M. Complicated actinomycosis of the temporal bone: a historical case report. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132 (04) 227-229
10 Townrow V, Barrie HJ. Fatal Actinomyces infection of the middle ear. J Laryngol Otol 1945; 60: 329
11 Sobol SE, Samadi DS, Wetmore RF. Actinomycosis of the temporal bone: a report of a case. Ear Nose Throat J 2004; 83 (05) 327-329
12 Pransky SM, Feldman JI, Kearns DB, Seid AB, Billman GF. Actinomycosis in obstructive tonsillar hypertrophy and recurrent tonsillitis. Arch Otolaryngol Head Neck Surg 1991; 117 (08) 883-885
13 Tarabichi M, Schloss M. Actinomycosis otomastoiditis. Arch Otolaryngol Head Neck Surg 1993; 119 (05) 561-562
14 Bennhoff DF. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope 1984; 94 (09) 1198-1217
15 Serrano E, Percondani J. Actinomycose cervicofaciale. Editions Techniques. Encycl Méd Chir (Paris), Otorhinolaryngologie. 1995 20-372-A-10:4
16 Hussein MR. Mucocutaneous Splendore-Hoeppli phenomenon. J Cutan Pathol 2008; 35 (11) 979-988
17 Belmont MJ, Behar PM, Wax MK. Atypical presentations of actinomycosis. Head Neck 1999; 21 (03) 264-268
18 Sullivan DC, Chapman SW. Bacteria that masquerade as fungi: actinomycosis/nocardia. Proc Am Thorac Soc 2010; 7 (03) 216-221
19 Smego Jr RA, Foglia G. Actinomycosis. Clin Infect Dis 1998; 26 (06) 1255-1261 , quiz 1262–1263
20 Hoshino T, Amano H, Tanaka K. Actinomycosis of the middle ear and mastoid. Eur Arch Otorhinolaryngol 1996; 253 (06) 378-380