title: Otorrhea as a sign of medical treatment failure in acute otitis media: two cases with silent mastoiditis complicated with facial palsy.
abstract: We report two children with otitis media who developed facial palsy despite prompt antibiotic therapy. Brain images revealed silent mastoiditis. Persistent otorrhea may be a cautious sign of medical treatment failure or complication of acute otitis media, including mastoiditis or facial palsy. Delayed identification of coexisting mastoiditis or hesitation over surgical intervention may lead to treatment failure and complications. Adequate intravenous antibiotics and myringotomy provide reasonable and appropriate management to prevent permanent sequelae.
authors.affiliation: Department of Pediatrics and Otorhinolaryngology, National Yang-Ming University Hospital, Yilan, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: mmozart@mail2000.com.tw.
authors.forename: Tzu-Chun
authors.initials: TC
authors.lastname: Tsai
authors.forename: Pang-Mien
authors.initials: PM
authors.lastname: Yu
authors.forename: Ren-Bin
authors.initials: RB
authors.lastname: Tang
authors.forename: Hsin-Kai
authors.initials: HK
authors.lastname: Wang
authors.forename: Ke-Chang
authors.initials: KC
authors.lastname: Chang
mesh_terms: D000208:Acute Disease; D002675:Child, Preschool; D005158:Facial Paralysis / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000209:etiology*; D010035:Otitis Media, Suppurative / Q000150:complications* / Q000188:drug therapy; D017211:Treatment Failure
keywords: Streptococcus pneumoniae; facial palsy; mastoiditis; otitis media; otorrhea