ACUTE BILATERAL OTITIS MEDIA IN AN 8-YEAR-OLD MALE PATIENT. CLINICAL CASE PRESENTATION

Abstract

DOI: https://doi.org/10.46296/gt.v8i16.0317

Abstract

Granulomatosis with polyangiitis, commonly referred to as Wegener's granulomatosis, is classified as a form of vasculitis that causes inflammation and necrosis. This disease primarily affects the small and medium-sized blood vessels in the human body. It is characterized by the appearance of granulomas, which are clusters of inflammatory cells, and can affect a variety of organs in the human body. However, this condition commonly has a particular predilection for involving the upper respiratory tract, as well as the lungs and kidneys. Early diagnosis is extremely important, as it plays a crucial role in preventing complications that could become very serious. Below we present a clinical case involving a young male patient only 8 years of age, with no significant medical history. This child came to our office complaining of severe pain in both ears, known as bilateral otalgia, as well as purulent ear discharge, or otorrhea, and a severe headache. Despite receiving appropriate antibiotic treatment, the child's symptoms persisted without improvement. A CT scan revealed an occupation of the middle ear and mastoid cells, indicating a possible complication of his condition. In addition, the clinical picture became even more complicated, as the patient presented with noticeable swelling around the eyes, known as periorbital edema, as well as decreased hearing in both ears, which led to a diagnosis of bilateral hearing loss. Interventions and results: Due to the persistence and worsening of the symptoms observed in the patient, a series of immunological tests were performed. These tests confirmed the presence of positive anti-neutrophil cytoplasmic antibodies (c-ANCA). In addition, a biopsy of the nasal mucosa was performed, which served to corroborate and validate the diagnosis of granulomatosis with polyangiitis (GPA). In conclusion, it is essential that early detection of the disease be carried out through serological tests and biopsies. This initial approach, when combined with appropriate immunosuppressive management, can significantly contribute to improving patient outcomes and, at the same time, help prevent the onset of complications that could aggravate their health status.

Keywords: Acute infection, Middle ear, Severe pain.