A Case of Multiple Myeloma Revealed by a Acute Otitis Media in Adults

Multiple myeloma or Kahler's disease is a malignant hemopathy characterized by a clonal proliferation of tumor plasma cells that invade the hematopoietic bone marrow. It is often discovered preferentially during spine, pelvis and ribs pain. Kahler's disease are rarely discovered during ENT infections. We report a case of a 58-year-old female patient that we exanimated in our ENT service for acute suppurative otitis media. The remainder of the examination revealed a swelling in the breast and functional impairment of the right upper limb. The maxillofacial CT- scan revealed lytic lacunar images of maxilla and cranial vault. Conventional X-ray displayed a fracture of the right humeral shaft. The positive diagnosis of multiple myeloma was made using bone marrow biopsy that has shown the presence of pathological plasmatic cells proliferation. Furthermore examination such as the plasma protein electrophoresis found hypo-gamma-globulinemia. Analysis of urinary sediment found κ -like Bence-Jones proteinuria. We provided Biphosphonates and analgesics treatment in addition to that of acute otitis media. Unfortunately, the death occurred six months later before he was able to benefit from a more invasive treatment protocol. This observation shows us that acute otitis media should not be trivialized, as it required a rigorous clinical examination and may surprise us.