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Subacute bacterial endocarditis secondary to mastoiditis: a rare complication
Caroline Patricia Smith1, Conor Jackson, Rosemary Stewart
1Department of ENT, Antrim Area Hospital, Antrim, UK. caroline_smith19@hotmail.co.uk
BMJ Case Reports
|December 4, 2012
Summary
Untreated otitis media can lead to mastoiditis and severe complications. This case highlights a rare instance of subacute bacterial endocarditis developing from mastoiditis, emphasizing the need for early detection to prevent mortality.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Cardiology
Background:
- Mastoiditis, an infection of the mastoid bone, often arises from inadequately treated otitis media.
- Delayed recognition of mastoiditis can precipitate severe, life-threatening conditions.
Observation:
- A 69-year-old female patient experienced a critical decline in consciousness (Glasgow Coma Scale) following symptoms of left-sided otitis media.
- Medical intervention revealed middle ear pus, identified as Group A Streptococcus, and persistent fever.
- Subsequent echocardiogram revealed subacute bacterial endocarditis.
Findings:
- Group A Streptococcus was isolated from both middle ear cultures and blood samples.
- The patient was diagnosed with subacute bacterial endocarditis, a rare complication stemming from mastoiditis.
- A comprehensive literature review found no prior documented cases of this specific complication.
Implications:
- This case underscores the critical importance of vigilant monitoring for complications associated with mastoiditis.
- Prompt diagnosis and management of mastoiditis are essential to avert severe morbidity and mortality.
- Heightened clinical suspicion for rare sequelae like bacterial endocarditis is crucial in managing complex otitis media cases.
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