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External Otitis: An Unusual Presentation in Neonates
Peymaneh Alizadeh Taheri1, Shima Rostami1, Manelie Sadeghi1
1Pediatrics Department, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Acute otitis externa (AOE), typically seen in children over 2, rarely affects newborns. This case details a 23-day-old infant with methicillin-sensitive Staphylococcus aureus AOE, successfully treated with cloxacillin.
Area of Science:
- Otolaryngology
- Neonatal Medicine
- Infectious Diseases
Background:
- Acute otitis externa (AOE) is a common ear infection primarily affecting children over two years old.
- Neonatal infections require prompt diagnosis and management due to potential complications.
Purpose of the Study:
- To report an unusual case of AOE caused by Staphylococcus aureus in a neonate.
- To highlight the importance of considering AOE in neonates presenting with ear discharge and irritability.
Main Methods:
- A case report of a 23-day-old female infant presenting with ear discharge and irritability.
- Clinical examination, otoscopy, and laboratory culture of ear discharge.
- Treatment with intravenous cloxacillin.
Main Results:
- The ear discharge culture identified methicillin-sensitive Staphylococcus aureus.
- The neonate showed significant clinical improvement within 48 hours of intravenous cloxacillin treatment.
- No signs of otitis media were observed.
Conclusions:
- This is the first reported case of methicillin-sensitive Staphylococcus aureus AOE in an immunocompetent newborn.
- Staphylococcal infections can present atypically in neonates, necessitating a broad differential diagnosis.
- Early recognition and appropriate antibiotic therapy are crucial for favorable outcomes in neonatal AOE.
Abstract:
Acute otitis externa (AOE) is an infection of the external auditory canal, the auricle, and the outer surface of the tympanic membrane. Although AOE is one of the most common otologic conditions encountered in pediatric population, it is known to primarily affect children older than 2 years. We report a case of AOE caused by Staphylococcus aureus in a 23-day-old neonate. A 23-day-old female infant presented to our neonatology clinic with irritability and discharge from the right ear. There were yellow otorrhea, mild erythema, and edema of right external ear canal. There was no sign of otitis media on otoscopy. The results of laboratory tests were insignificant. The discharge culture grew colonies of methicillin-sensitive Staphylococcus aureus. After 48 hours of treatment with intravenous cloxacillin, significant improvement was observed. The present case highlights an unusual presentation of staphylococcal infection in a neonate. This is the first case of methicillin-sensitive Staphylococcus aureus otitis externa in an immunocompetent newborn.
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