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Actinomycosis of the middle ear
T S Olson1, A B Seid, S M Pransky
1Children's Hospital and Health Center, San Diego, CA.
International Journal of Pediatric Otorhinolaryngology
|February 1, 1989
Summary
Actinomycosis is a rare middle ear infection caused by Actinomyces israelii. Diagnosis often relies on identifying sulfur granules, with treatment involving tympanomastoidectomy and oral penicillin.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Actinomycosis is an uncommon middle ear infection.
- Few cases have been documented in English literature.
- Actinomyces israelii, an anaerobic, filamentous bacterium, is the causative agent.
Observation:
- The infection is typically chronic and difficult to diagnose before surgery.
- Small, yellow, glue-like masses known as sulfur granules are key diagnostic indicators.
- Tympanomastoidectomy is often required for diagnosis and treatment.
Findings:
- Actinomyces israelii is the primary pathogen responsible for this rare otologic condition.
- Sulfur granules are pathognomonic for actinomycosis, aiding in diagnosis.
- The organism's anaerobic nature complicates laboratory culture and diagnosis.
Implications:
- Early recognition of sulfur granules can lead to timely diagnosis of middle ear actinomycosis.
- Surgical intervention (tympanomastoidectomy) is crucial for management.
- Prolonged oral antibiotic therapy, typically penicillin, is recommended post-surgery.