A Case of Middle Ear Actinomycosis Treated by Non-Surgical Method

Actinomycosis is a chronic suppurative infection by Actinomyces species, which rarely involves the middle ear and seldom diagnosed prior to tympanomastoidectomy. Unlike actinomycosis of the other body part, surgical removal is generally conducted in middle ear actinomycosis. We present the case of a 72-year-old female with 1-month history of otalgia and otorrhea in the left ear. Otoscopic examination revealed voluminous granulation tissue obstructing the ear canal with serous discharge. Excisional biopsy of the granulation tissue revealed actinomycosis. Tympanomastoid surgery was advised to treat presumed residual mastoid disease, but it was refused by the patient. 2 weeks of intravenous antibiotics and 6 months of penicillin was administered, and with a follow-up of 2 years she is free of symptom. Early diagnosis of actinomycosis and proper medication with antibiotics could control the symptoms and disease without surgery in some selected cases. (J Clinical Otolaryngol 2015;26:248–252)