Actinomycosis of the Middle Ear and Mastoid

Abstract

Introduction:Actinomycosis is a saprophytic infection caused by actinomycetes. Actinomycetes is a gram positive, anaerobic, non acid-fast, filamentous bacterium. Although actinomyce is considered as a part of the normal flora, it is rarely seen in middle ear and mastoid cavity.Aim:is to report a rare case of Actinomycosis infection of the middle ear and mastoid cavity.Case report:We presented A 24 years old male arrived to our outpatient department complaining of right-sided otalgia and hearing loss for 8 years, no history of otorreah, vertigo or dizziness. He had a history of right-sided chronic suppurative otitis media with a history of two operations at the same side. This report suggests that actinomycosis , although it is rare, it could occurs in middle ear. It should be considered as one of the differential for chronic suppurative otitis media patients with no improvement on medical treatment.Conclusion:Combined medical and surgical treatment is the recommended management for Actinomycosis infection of the middle ear and mastoid cavity.

Actinomycosis of the Middle Ear Mimicking Cholesteatoma: A Case Report and Literature Review

“…It is a saprophytic infection caused by Actinomyces. Actinomyces is a gram-positive, anaerobic, non-acid-fast, filamentous bacterium [ 1 , 2 ]. They are part of the normal flora of the oropharynx, digestive, and genital tracts [ 3 ].…”

“…These organisms form an inflammatory granuloma with a fibrous pseudo-capsule, appearing as yellow granules macroscopically [ 8 ]. Middle ear actinomycosis is characterised by abscesses, tissue fibrosis, and draining sinuses [ 1 ].…”

“…Before the antibiotic era, actinomycosis was seldom detected prior to autopsy - most of these infections were fatal due to their intracranial involvement [ 1 ]. Some of the intracranial complications include petrous apicitis, subdural abscess, and sinus thrombosis [ 7 ].…”