Mastoiditis can result from untreated otitis media. If unrecognised, it can result in life-threatening complications. We present a 69-year-old woman with a history of left-sided otitis media admitted to intensive care unit following collapse with a decreasing Glasgow Coma Scale. Myringotomy and ventilator insertion revealed pus in the middle ear, which grew Group A Streptococcus. Her fever persisted and blood samples cultured Group A Streptococcus. Echocardiogram confirmed subacute bacterial endocarditis. Subacute bacterial endocarditis is a rare complication of mastoiditis. A literature review detected no previous case reports. A high suspicion of potential complications can prevent morbidity and mortality.

Eagle syndrome is characterized by the presence of an abnormally elongated styloid process and has been related to different etiologies, including enthesitis, a known feature of spondyloarthropathies. We are describing a case of marked elongation of the styloid process in a patient with pre-existing ankylosing spondylitis and associated enthesopathy.