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.
Keywords
Coronavirus
COVID-19
Otitis media
X-ray
Reverse transcriptase–polymerase chain reaction
1. 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.
2. 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.
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Fig. 3. Chest X-ray of patient.
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).
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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.
3. 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.
References
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