A rare case of tympanostomy tube otorrhea: Pigmentiphaga

Samuel J Rubin; Claire M Lawlor; Gi Soo Lee

doi:10.1016/j.ijporl.2020.110165

A rare case of tympanostomy tube otorrhea: Pigmentiphaga

Int J Pediatr Otorhinolaryngol. 2020 Sep:136:110165. doi: 10.1016/j.ijporl.2020.110165. Epub 2020 Jun 4.

Authors

Samuel J Rubin¹, Claire M Lawlor², Gi Soo Lee³

Affiliations

¹ Department of Otolaryngology and Communication Disorders, Boston Children's Hospital, Boston, MA, USA; Department of Otolaryngology, Boston Medical Center, Boston, MA, USA.
² Department of Otolaryngology and Communication Disorders, Boston Children's Hospital, Boston, MA, USA; Division of Pediatric Otolaryngology, Children's National Hospital, Washington D.C, USA.
³ Department of Otolaryngology and Communication Disorders, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: gi.lee@childrens.harvard.edu.

PMID: 32570062
DOI: 10.1016/j.ijporl.2020.110165

Abstract

Tympanostomy tube otorrhea (TTO) is a common complication of tympanostomy tubes. The most common bacteria associated with TTO include Haemophalis influenza, Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa. We present the first case of a 9 year-old female with a history of 22q11 syndrome, hemifacial microsomia, Tetralogy of Fallot, and hearing aid dependence with left-sided profound sensorineural and right-sided moderate conductive hearing loss who presented with TTO caused by the bacteria Pigmentiphaga daeguenesis/kulla, a gram-negative bacteria often found in soil. This patient's otorrhea did not respond to typical otic antibiotic formulations, but was ultimately treated successfully with intramuscular ceftriaxone. We describe the natural history, presentation and management for a case of TTO caused by a rare bacteria from the genus Pigmentiphaga.

Keywords: Microbiology; Pediatric otolaryngology; Pigmentiphaga; Tympanostomy tube otorrhea.

Publication types

Case Reports

MeSH terms

22q11 Deletion Syndrome / complications*
Alcaligenaceae*
Anti-Bacterial Agents / therapeutic use
Ceftriaxone / therapeutic use
Child
Ear Diseases / diagnosis
Ear Diseases / drug therapy
Ear Diseases / microbiology*
Female
Humans
Middle Ear Ventilation / adverse effects*
Pseudomonas aeruginosa
Staphylococcus aureus

Substances

Anti-Bacterial Agents
Ceftriaxone

Supplementary concepts

Pigmentiphaga daeguensis
Pigmentiphaga kullae