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Published on: December 19, 2014

Macrophage activation syndrome triggered by Candida parapsilosis-related cochlear implant infection

Begum Bahar Yilmaz1, Muhammed Talha Karadogan2, Alper Tabaru3

  • 1Otorhinolaryngology and Head and Neck Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey. begumbahar.bbb@gmail.com.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|July 5, 2026
PubMed
Abstract

Insights

Cochlear implant infections can cause severe Macrophage Activation Syndrome (MAS) in children. This case highlights the importance of early recognition and multidisciplinary treatment for improved outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Critical Care Medicine
  • Otolaryngology

Background:

  • Cochlear implant (CI) infections are rare but can lead to severe systemic complications.
  • Macrophage Activation Syndrome (MAS) is a life-threatening hyperinflammatory condition.
  • Pediatric cases of MAS secondary to CI infection have not been previously documented.

Purpose of the Study:

  • To report the first pediatric case of MAS triggered by a cochlear implant infection.
  • To emphasize the diagnostic challenges and treatment strategies for CI-related MAS.
  • To highlight the critical role of a multidisciplinary approach in managing such rare complications.

Main Methods:

  • Case presentation of a 13-year-old female with MAS secondary to Candida parapsilosis sepsis from a CI.
  • Diagnostic workup included HLH-2004 criteria fulfillment, revealing pancytopenia, hyperferritinemia, and liver failure.
  • Treatment involved plasmapheresis, high-dose corticosteroids, CI explantation, and subsequent reimplantation.

Main Results:

  • The patient developed MAS despite broad-spectrum antimicrobial and antifungal therapy.
  • Clinical recovery was achieved following a multidisciplinary treatment approach including CI explantation.
  • Candida parapsilosis was identified as the causative pathogen, known for biofilm formation.
  • Successful cochlear implant reimplantation was performed two months post-explantation.

Conclusions:

  • Cochlear implant-related infections can lead to severe systemic complications like MAS.
  • This is the first reported pediatric case of MAS associated with cochlear implant sepsis.
  • Early diagnosis and prompt multidisciplinary management are crucial for improving survival and outcomes in pediatric CI-related MAS.
Keywords:
Biofilm infectionCandida parapsilosisCochlear implantExplantationHemophagocytic lymphohistiocytosisImplant-related infectionMacrophage activation syndromePediatric

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