Acute otitis externa diffusa is usually caused bacterially by Pseudomonas aeruginosa,
Staphylococcus aureus or mixed infections. Rarely, other pathogens are also considered,
as shown in this case report. A 38-year-old male patient presented with otorrhea that
had been present for 3 weeks, a feeling of pressure in the right ear, and concomitant
hearing loss on the right side. Prior to the onset of symptoms, the patient had been
in Moscow to work in the sewer system. An alio loco ear swab had tested questionably
positive for Vibrio cholerae. Ear microscopy revealed a reddened, discretely swollen
canal on the right side; the tympanic membrane was slightly reddened and covered with
scales. The result of our microbiological examination of the ear swab was negative.
Only molecular genetic testing using a PCR gastroenteritis panel provided qualitative
evidence of Vibrio spp. DNA, confirming an acute ear infection with Vibrio cholerae. Therapy
included systemic administration of ciprofloxacin for 7 days and topical application
of ciprofloxacin for 6 weeks. Vibrio cholerae is considered a typical but very rare
pathogen of the gastrointestinal tract that leads to the infectious disease cholera. With
an appropriate travel and occupational history and a progression of disease, infection
with rare gastrointestinal tract pathogens such as Vibrio spp. should also be considered
as a cause of otitis externa.
