Clinical Problem Solving: Pathology
Feb 2012

Pathology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2012;138(2):203. doi:10.1001/archoto.2011.1222a

A 61-year-old man presented with severe otalgia and otorrhea. He had a 35-year history of right-sided intermittent otorrhea, aural fullness, and tinnitus and a 3-month history of decreased balance. Topical and systemic antibiotic therapy was initiated, but his symptoms persisted, and new symptoms of severe facial pain and fever developed. He had no history of immunocompromise. Physical examination revealed an edematous, mildly erythematous right external auditory canal, with purulent discharge obscuring the tympanic membrane. There was no pain with movement of the pinna. Temperature, light touch, and sharp and dull stimuli were reduced in the right trigeminal distribution.

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