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Postauricular feather foreign body in an infant
Aayushi Hemmad1, Ayla Serena Tabaksert2, David Ashley Lowe2
1Ear, Nose and Throat, James Cook University Hospital, Middlesbrough, UK aayushi.hemmad2@nhs.net.
Insights
A rare case of a soft tissue foreign body, a sofa cushion feather, caused postauricular swelling in an infant. This highlights the need to consider unusual causes when antibiotics fail to resolve persistent pediatric swelling.
Area of Science:
- Pediatric Medicine
- Otolaryngology
- Dermatology
Background:
- Postauricular swelling in infants can mimic infections like mastoiditis.
- Antibiotic treatment is standard for suspected bacterial causes of such swelling.
Purpose of the Study:
- To report an unusual case of postauricular swelling caused by a soft tissue foreign body.
- To emphasize the importance of considering non-infectious etiologies in pediatric postauricular swelling.
Main Methods:
- Clinical presentation and examination of a male infant with postauricular swelling.
- Diagnostic imaging (cross-sectional) to rule out middle ear and mastoid infections.
- Observation of clinical response to intravenous antibiotics.
- Identification of a self-extruded foreign body.
Main Results:
- Infant presented with fever, reduced oral intake, and postauricular swelling.
- Imaging excluded middle ear infection and mastoiditis.
- Swelling showed minimal improvement with antibiotics.
- A feather foreign body was identified after self-extrusion.
Conclusions:
- Soft tissue foreign bodies are a rare but important differential diagnosis for pediatric postauricular swelling.
- Failure to respond to antibiotics should prompt consideration of unusual etiologies.
- Prompt identification and removal of foreign bodies are crucial for resolution.
Abstract:
A male infant presented with reduced oral intake, low-grade fever and postauricular erythema. Clinical examination revealed a soft, tender swelling posteroinferior to the mastoid tip with a dull tympanic membrane on otoscopy. Cross-sectional imaging did not show any evidence of middle ear infection or mastoiditis. However, there was minimal change in clinical status despite trialling various intravenous antibiotics. One week after admission, a thin, white foreign body self-extruded from the upper part of the postauricular skin, recognised by the child's parents as a feather from their sofa cushion. The suspected mechanism was the penetration of the feather into the skin when the child was lying on the sofa. While incredibly rare, soft tissue foreign bodies should be considered in paediatric patients with postauricular swelling not responding to antibiotics.
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