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Bilateral Mastoiditis from Red Tide Exposure

  • Samantha Honner, MD

      Affiliations

    • Department of Emergency Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California
    • Corresponding Author InformationReprint Address: Samantha Honner, md, Department of Emergency Medicine, Alta Bates Summit Medical Center, 350 Hawthorne Avenue, Oakland, CA 94609
    • ,
  • Raphael M. Kudela, PhD

      Affiliations

    • Ocean Sciences and Institute for Marine Sciences, University of California Santa Cruz, Santa Cruz, California
    • ,
  • Ethan Handler, MD

      Affiliations

    • Department of Otolaryngology, Kaiser Permanente Oakland Medical Center, Oakland, California

Received 19 February 2009; received in revised form 27 April 2010; accepted 12 June 2010. published online 30 August 2010.
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Abstract 

Background

Bilateral mastoiditis in adults has previously been reported only in association with diabetes mellitus or immunocompromised patients.

Objectives

To describe a case of bilateral mastoiditis in a healthy adult and to investigate the etiology.

Case Report

A 53-year-old woman presented to the Emergency Department with bilateral otitis externa and mastoiditis after scuba diving during a harmful algal bloom, commonly known as a “red tide.” The levels of coliform bacteria recorded at the time and location of her dive exceeded health regulatory limits and correlate with her atypical culture results.

Conclusion

Elevated bacterial counts that result from harmful algal blooms may account for this rare infection.

Keywords: bilateral mastoiditis, bilateral otitis externa, harmful algal bloom, red tide, scuba diving

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 Environmental data and analysis were supported by funding to RMK through National Oceanic and Atmospheric Administration (NOAA) MERHAB award NA04NOS4780239, and by the Central and Northern California Ocean Observing System through NOAA award NA08NOS4730382.

PII: S0736-4679(10)00517-2

doi:10.1016/j.jemermed.2010.06.007

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