Introduction
In general, acute otitis media means all acute inflammation in tympanum. In the early stage, symptoms such as rubefaction and expansion of eardrum, feeling of being filled, ear pain, and fever can occur, and in the case of eardrum perforation, otorrhea can occur. In most cases, acute otitis media are known to be cured naturally or through medicine well.
This case report examined the patient who suffered constantly due to headache because of the failure to find the cause from headache and nuchal pain for a month despite various evaluation, but had the pain removed after the treatment of acute otitis media which was coincidentally found.
Case presentation
A female patient aged 84 was being observed for cervical radiculopathy from February 5th, 2007 until now as an outpatient of the rehabilitation department of this hospital. As the patient suffered HTN, DM, hyperlipidemia, and osteoarthritis in the past, she in being treated.
Around May 16th, 2018, In car TA occurred and received treatment at another hospital. At that time, based on brain CT, there were no particular opinion, the patient went home. The patient reported that besides a little numbness in the upper body, the patient had no difficulty in living a daily life. In one week, headache and nuchal pain occurred, due to that the patient visited ER of other hospitals and this hospital, and radiologic evaluations such as brain CT, brain MRI, cervical MRI were conducted. But as there were no particular opinion, the patient was recommended to observe the condition over time. Afterwards, because the pain continued, r/o MPS was conducted for posterior neck and UTZ parts of TPI, but the condition did not improve.
After that, for a month the patient suffered headache and nuchal pain, and the feeling of being filled in the ear occurred. After the ENT treatment, acute otitis media was confirmed, after medicine treatment for that was conducted, the pain was completely eased.
Conclusion
This patient was continuously observed for cervical radiculopathy since 2007, during that period nuchal pain occurred twice and the patient received medicine treatment and TPI in the past. The pain occurred this time occurred after a car accident. Brain and cervical evaluation was conducted, but as there were no particular opinion, due to the possibility of r/o MPS of the past history, TPI, which was conducted usually, was implemented. However, the cause of pain was found to be acute otitis media.
The general symptom of acute otitis media is pain in the ear rather than nuchal pain. The sense of being filled in the ear, difficulty in hearing, and fever are accompanied. Therefore, in the case of non-particular patient who has just nuchal pain with no additional symptoms, early diagnosis is not easy. Accordingly, in the case of patient with headache with unclear cause, and sustained nuchal pain, ENT evaluation such as acute otitis media would be helpful. |
