Labyrinthine involvement and multiple perforations of the tympanic membrane in acute otitis media due to group A streptococci

Abstract

We present here three cases of acute otitis media caused by a virulent group A streptococcal infection that rapidly led to deterioration in hearing. Two of the three cases presented with severe sensorineural and mixed hearing loss with multiple tympanic membrane perforations, and the third presented with severe bilateral sensorineural hearing loss following acute otitis media involving group A streptococci. All patients were treated with systemic (piperacillin) and topical antibiotics (ofloxacin ear drops): one patient also received a systemic steroid (betamethasone). Deafness persisted in one patient but in the other two, hearing gradually recovered. Severe cytotoxicity was considered to have occurred in all patients, resulting in multiple perforations of the tympanic membrane and necrosis in the middle ear.

Acute otitis media associated bilateral sudden hearing loss: case report and literature review

“…Kanazawa et al . describe a case of bilateral sudden SNHL secondary to acute otitis media caused by group A streptococci, and complicated by multiple tympanic perforations and necrosis of the middle-ear cavity 14 . Other factors likely contributed to this patient's hearing loss, beyond acute otitis media.…”

“…Five case series and one case study report unilateral SNHL associated with acute otitis media, with a total of 46 patients described (Table II). 5 , 14 – 18 Common findings of note within the literature include a high prevalence of bacterial pathology and tinnitus, and favourable treatment outcomes with early myringotomy (with or without ventilation tubes) and antibiotics.…”

A Rare Case of Tarceva Resulting in Tympanic Membrane Necrosis

“…This is one true otolaryngological emergency necessitating immediate attention. Virulent strain of group A streptococcus associated with acute otitis media or otomycosis in immunocompromised hosts resulting in TM necrosis have also been reported [4,5]. Lastly, TM necrosis has been linked to osteonecrosis from radiation in patients with breast and prostate cancer, and multiple myeloma [6,7].…”