Hemotympanums secondary to spontaneous epistaxis in a 7-year-old

Hurtado, Timothy R.; Zeger, Wesley

doi:10.1016/j.jemermed.2003.05.001

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…Common causes of hemotympanum in childhood are chronic otitis media, basilar skull fractures after head trauma, nasal packing, and bleeding disorders related with anticoagulant drugs [4][5][6][7]. In this case, hemotympanum developed rapidly, and no predisposing cause other than ITP was found.…”

Section: Resultsmentioning

confidence: 92%

“…Skin and mucosal bleeding usually presents as petechiae, purpura, ecchymosis and epistaxis. A few cases have been reported with unusual bleeding such as spontaneous gingival bleeding, hematomas of the mucosa, massive intra-abdominal bleeding because of spontaneous rupture of an ovarian follicle cyst, subconjunctival or retinal bleeding [7][8][9][10].…”

Section: Resultsmentioning

confidence: 99%

“…Hemotympanum is defined with the usage of anticoagulant drug, bleeding disorder, therapeutic nasal packing, epistaxis, and secondary to head trauma, but no ITPrelated hemotympanum case was reported in the literature [4][5][6][7]. We present a boy with spontaneous bilateral hemotympanum associated with ITP presenting with acute hearing loss.…”

Section: Introductionmentioning

confidence: 99%

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Immune thrombocytopenic purpura-related hemotympanum presenting with hearing loss

Fışgın

Atmaca

Duru

et al. 2009

Blood Coagulation &Amp; Fibrinolysis

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A 5-year-old boy was admitted to our center with a major complaint of bilateral hearing loss for 2 days. He was diagnosed with acute immune thrombocytopenic purpura 3 months before the admission and treated with high-dose methylprednisolone 2 months ago. Physical examination revealed wet purpura in the oral mucosa, serous nasal discharge, multiple petechiae and ecchymosis of the lower lip. Otomicroscopic ear examination revealed the presence of bilateral hemotympanum. The patient denied head trauma, ear pain, fever, hypertension and medications, including salicylates. The patient received high-dose intravenous methylprednisolone because of low platelet count and wet purpura for 7 days and oral prophylactic amoxicillin-clavulanate for 14 days. The onset of the response to corticosteroids was rapid, and significant hematologic improvement was observed within a few days. The 2-week follow-up examination revealed intact tympanic membranes with normal color and mobility, and the patient restored normal hearing. In this patient, hemotympanum developed rapidly, and no predisposing cause other than immune thrombocytopenic purpura was found. However, presence of a serous nasal discharge may be a sign of viral upper respiratory tract infection. Therefore, it can be speculated that sneezing or coughing might have caused bilateral hemotympanum by increasing the middle ear pressure abruptly. We would like to emphasize that bleeding may occur in unusual sites and, unlike in healthy people, may cause bizarre symptoms in patients with bleeding diathesis. Hemotympanum can be considered among the indications to start treatment in patients with acute immune thrombocytopenic purpura.

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Section: Resultsmentioning

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Immune thrombocytopenic purpura-related hemotympanum presenting with hearing loss

Fışgın

Atmaca

Duru

et al. 2009

Blood Coagulation &Amp; Fibrinolysis

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“…In hemotympanum, the involved tympanic membrane may appear red or dark blue to near black in color depending on the age of the blood 1–3. The presence of blood in the tympanic cavity can lead to conductive or mixed pattern of hearing loss 4,5. Patients will typically complain of an acute onset decreased ability to hear in the affected ear.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Spontaneous Hemotympanum Secondary to Chemotherapy-Induced Thrombocytopenia

Wong

Gomaa

et al. 2013

Clin Med Insights Ear Nose Throat

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ObjectiveTo present a case of spontaneous, bilateral hemotympanum secondary to chemotherapy-induced thrombocytopenia.MethodsCase report and review of the literature.ResultsBilateral spontaneous hemotympanum is an exceedingly rare event. We present the first case of nontraumatic bilateral hemotympanum secondary to chemotherapy-induced thrombocytopenia in a patient with acute myelogenous leukemia. The patient presented with a 7-day history of progressive bilateral hearing loss and a platelet count of 10 × 109/L after receiving his first dose of induction chemotherapy. A small, left-sided subdural hematoma was present in this patient though no extra-aural sources of bleeding to explain the bilateral hemotympanum were identified.ConclusionFull resolution of symptoms was achieved with conservative management.

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“…Only six cases associated with spontaneous epistaxis have been described in the literature [1,2]. Because of this rare situation, we present the case of a 51-year-old woman with bilateral hemotympanum secondary to spontaneous epistaxis.…”

Section: Introductionmentioning

confidence: 99%