Gligor, Razvan, Kiss, Erik-Karoly, Tudor, Lazar, Laslo, Laura, Ivan, Valentin-Gabriel, and Cighir, Anca
Introduction: Otitis media is an ear inflammation which is characterized by excruciating pain, fever, a sensation of fullness and fluid drainage from the middle ear. Inflammation of the middle ear that follows a pathogenic microorganism infection is known as otitis syndrome. If the infection affects the ear canal, it can be external; if it affects the eardrum area, it can be medial. The main etiological agents involved in otitis media are bacteria such as Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae. Case Report: We present the case of a 4-month-old patient, who presented to the Targu Mures Emergency Department with fever (39.2 ... and otorrhea of the left ear. The mother reports that the symptoms started the day before. Along with the clinical examinations of the patient, purulent discharge from the ear was taken and sent to the laboratory for microbiological diagnostic. The sample was inoculated on the usual culture media and then incubated for 24 hours at 37 ... On Chocolate agar, the appearance of small, transparent, pearl-like, S-type colonies was observed. On blood agar, the appearance of the satellitism phenomenon was observed, as the colonies were only growing in the presence of the staphylococcal strains of the newborn's integumentary flora. The microscopic examination of the culture showed polymorphic gram-negative cocobacilli, suggestive of Haemophilus spp. For further identification to the level of species, the growth factor test was performed, along with automatic identification using Vitek 2 Compact (BioMerieux). Both tests identified the bacteria as Haemophilus influenzae. Discussions : Antibiotic susceptibility testing for Haemophilus influenzae should be performed on Mueller Hinton agar with 5% horse blood (a media used for highly fastidious bacteria) and incubated in CO2 atmosphere. In our case, the bacteria showed susceptibility to the usual antibiotics tested for these types of strains, but a lot of the strains are known to have resistance to routinely used antibiotics, such as amoxicillin. The antibiotics for treating such infections should be chosen carefully, as it can easily become a cronic infection if not treated properly. Conclusions: Diagnosing and treating Haemophilus influenzae otitis media can be challenging. In the current case, as the strain was susceptible to most antibiotics, the infection was treated by giving both systemic treatment (Cefuroxime) and topical ear drops with Ciprofloxacin. The evolution of the patient under treatment was favorable, towards healing. [ABSTRACT FROM AUTHOR]