2022 Volume 68 Issue 6 Pages 403-410
Mycoplasma infections can present with a wide variety of systemic symptoms that may be accompanied by preceding symptoms, such as a fever. We herein report a case of bilateral mixed hearing loss and bilateral facial paralysis secondary to mycoplasma pharyngitis and otitis media. A 14-year-old girl visited our department (day 1) with a chief complaint of a fever and bilateral earache for the past several days. Bilateral otitis externa, bilateral otitis media, and nasopharyngitis were observed. The patient was started on CTRX on the same day, and prednisolone was tapered due to the appearance of left facial nerve palsy on day 2. Pure-tone audiometry showed moderate bilateral mixed hearing loss. On day 6, the patient was found to be positive for mycoplasma complement binding reaction and was switched to AZM. On day 16, right facial nerve palsy was observed, and steroid treatment was given again. The bilateral osteogenesis thresholds and right facial nerve palsy improved, but left facial nerve palsy showed no improvement, so left facial nerve decompression was performed on day 65. In cases of facial nerve palsy with preceding symptoms and acute sensorineural hearing loss, mycoplasma infection should be considered as a differential diagnosis.
