Human immunodeficiency virus and invasive external otitis--a case report

Area of Science:

• Infectious Diseases
• Otolaryngology
• Immunology

Background:

• Acute invasive external otitis (AIEOT) is a severe infection of the external auditory canal (EAC).
• It typically affects elderly diabetic patients, with rare reports in Human Immunodeficiency Virus (HIV)-positive individuals.
• Early identification and management are crucial due to its potentially life-threatening nature.

Observation:

• A 25-year-old immunocompetent nursing mother presented with a month of fever, otalgia, and severe left ear canal inflammation.
• Symptoms progressed to facial cellulitis, mastoid abscess, and facial nerve palsy after minor ear trauma.
• An underlying immunodeficiency was suspected due to the unusual severity and course of the infection.

Findings:

• Diagnostic workup confirmed Human Immunodeficiency Virus (HIV) infection as the predisposing factor.
• The patient's presentation demonstrated atypical features of AIEOT in an immunocompromised young adult.
• Invasive external otitis can manifest unusually in HIV-positive patients.

Implications:

• This case underscores the importance of considering HIV in young adults presenting with severe or unusual external otitis.
• Prompt diagnosis of HIV is critical for effective management of opportunistic infections like AIEOT.
• Clinicians should be aware of the diverse clinical presentations of AIEOT in immunocompromised populations.