[Diagnostic and Therapeutic Challenges of Otogenic Fusobacterium Necrophorum Infections: A Case Report]

Acute mastoiditis is an infectious complication of acute otitis media, potentially leading to life-threatening extracranial and intracranial sequelae. In recent years, there has been a noticeable shift in the epidemiology of causative pathogens, with an increasing incidence of less common bacteria. This article presents the case of a 1.5-year-old child diagnosed with acute mastoiditis and additional complications, who failed to respond to empirical antibiotic therapy and had persistently negative cultures. Only through the use of polymerase chain reaction (PCR) testing was the causative organism, Fusobacterium necrophorum, identified. We discuss the epidemiological and clinical features of F. necrophorum, the diagnostic challenges due to its difficult cultivation, treatment approaches, distinctive imaging findings, and the role of advanced imaging in patient follow-up. This case highlights the importance of recognizing this pathogen in culture-negative mastoiditis, the need for early consideration of PCR testing, tailored antibiotic and surgical management based on disease severity, and the necessity of radiological follow-ups.