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Clinical Problem Solving: Pathology
January 18, 2010

Pathology Quiz Case 2: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2010;136(1):103-105. doi:10.1001/archoto.2009.181-b

Twenty cases of P cariniiinfection of the temporal bone have been described in the English-language literature since the first report 2 decades ago.1In most cases, infected patients have no history of P cariniipneumonia or concurrent evidence of pulmonary disease.2The clinical symptoms are nonspecific and can include hearing loss, otalgia, otorrhea, otorrhagia, vertigo, and tinnitus.3Patients typically present with a mass in the EAC. In some cases, there is bilateral temporal bone involvement. The presence of concomitant otitis media or acute mastoiditis is variable.48Destruction of the ossicles, poor aeration and sclerosis of the mastoid air cells, extensive bony erosion, and extension into the middle cranial fossa have all been previously reported.7,9None of the previously reported cases of P cariniiotomastoiditis have described facial paralysis resulting from the infection.

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