Bilateral mastoiditis from red tide exposure.
BACKGROUND
Bilateral mastoiditis in adults has previously been reported only in association with diabetes mellitus or immunocompromised patients.


OBJECTIVE
To describe a case of bilateral mastoiditis in a healthy adult and to investigate the etiology.


METHODS
A 53-year-old woman presented to the Emergency Department with bilateral otitis externa and mastoiditis after scuba diving during a harmful algal bloom, commonly known as a "red tide." The levels of coliform bacteria recorded at the time and location of her dive exceeded health regulatory limits and correlate with her atypical culture results.


CONCLUSIONS
Elevated bacterial counts that result from harmful algal blooms may account for this rare infection.
Honner
Samantha
S
Department of Emergency Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA.
Kudela
Raphael M
RM
Handler
Ethan
E
D000700:Analgesics / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004242:Diving / Q000009:adverse effects*; D004433:Earache / Q000188:drug therapy / Q000382:microbiology; D016983:Enterococcus; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000188:drug therapy; D057097:Harmful Algal Bloom; D006801:Humans; D008417:Mastoiditis / Q000209:etiology / Q000382:microbiology*; D008875:Middle Aged; D010032:Otitis Externa / Q000209:etiology / Q000382:microbiology*; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy; D011550:Pseudomonas aeruginosa
D000700:Analgesics; D000900:Anti-Bacterial Agents