A 15-MONTH-OLD girl developed a right facial nerve palsy (Figure 1) while receiving oral treatment with amoxicillin for a sore throat and bilateral otitis media of one week's duration. On physical examination, bilateral otomastoiditis, perforation of the left tympanic membrane, and right-sided cervical lymphadenopathy were found. Bilateral mastoidectomy/antrotomy was performed: on gross inspection, the mucosa appeared dark red, swollen, and polypoid. The diagnostic histological findings of the biopsy specimens are shown in Figure 2 and Figure 3. Oral steroids were given for 5 days, and amoxicillin–clavulanic acid was administered intravenously for 14 days. At follow-up 4 months later there was complete recovery including resolution of the nerve deficit.
Accepted for publication August 26, 1999.
Corresponding author: R. Hubert Laeng, MD, Department of Pathology, Kantonsspital, CH-5001 Aarau, Switzerland (e-mail: email@example.com).
Laeng RH, Stähelin J, Schaller P, Arnoux A. Pathological Case of the Month. Arch Pediatr Adolesc Med. 2002;156(2):191. doi:10.1001/archpedi.156.2.191