New type of corona virus induced acute otitis media in adult.

Since late December 2019, a new type of coronavirus (CIVID-19) causing a cluster of respiratory infections was first identified in Wuhan-China. And it disseminated to all countries. Generally, COVID-19 cases have fever, cough, respiratory distress findings (dyspnoea, intercostal retraction, cyanosis etc.). In this paper, we have presented an adult otitis media case whom infected with COVID-19, but she have not any classical COVID-19 symptoms.

Introduction

The detection of coronavirus that is the cause of severe acute respiratory syndrome, dates back to 1900s [1].

In December 2019, an outbreak of a coronavirus disease (COVID-19) originated from China and expeditiously distributed to all of world [2]. The WHO announced the COVID-19 as a pandemic disease on March 2020 [3]. We acknowledge that 80% of cases show with mild disease and the entire case-fatality rate is about 2.3% but goes to 14.8% in patients aged over 80 years [4].

Among adult patients, cardiovascular disease, hypertension and diabetes mellitus were the most usual inherent diseases. Fever (92.8%), cough (69.8%), dyspnoea (34.5%), myalgia (27.7%), headache (7.2%), diarrhoea (6.1%), rhinorrhoea (4.0%), sore throat (5.1%) and pharyngalgia in 17.4% are all published signs [5].

In the present case, we report a 35-year-old female patient with a previously undefined otalgia and tinnitus who was diagnosed with COVID-19 on physical examination, reverse transcriptase–polymerase chain reaction (RT-PCR) tests and radiographic studies.

Case report

A 35-year-old female patient presented to our clinic with otalgia and tinnitus. She has not any published COVID-19 symptoms. The patient has not any comorbid diseases.

There was hyperemia and bulging tympanic membrane in her otorhinolaryngologic examination (Fig. 1 ). But there was mild rhonchi at lower part of thorax.

Fig. 1

Otoscopic finding of ear.

The patient underwent audiometry and tympanometry tests. In terms of roncus detected in the examination, further examinations (chest X-ray, real-time reverse transcriptase–polymerase chain reaction (RT-PCR)) were requested due to the pandemic status of world.

There was conductive hearing loss in audiometry and type-b appearance in tympanometry in right ear (Fig. 2 ). Also there was bilateral lung involvement in chest X-ray and positive RT-PCR result about COVID-19 (Fig. 3 ).

Fig. 2

Audiometry of patient.

Fig. 3

Chest X-ray of patient.

Antiviral treatment (75 mg of oseltamivir taken orally every 12 h, 7 days) was provided. The patient was kept at her home to continue the quarantine protocol for 14 days. The RT-PCR tests were repeated 7 and 13 days later. After the treatment, it was determined that the pcr test result was negative and the chest X-ray was normal.

Discussion

The outbreak of COVID-19 has become a clinical threat to the world. Our knowledge about COVID-19 is limited. Different methods including antiviral therapy and chloroquine therapy are tried worldwide. As with all pandemics, COVID-19 should be kept under close monitoring, as the more we learn about this novel virus. But clinicians must be kept in mind that COVID-19 can manifest itself with different findings, without the classic symptoms and complete body examination is most important in evaluation of patients.