Refractory chronic otitis media and mixed hearing loss due to infection with levaquin-resistant KERSTERSIA GYIORUM: A case report and review of the literature

A 39-year-old Caucasian male, with a past medical history of purulent drainage of both ears as an infant and multiple tympanostomy tube placements in childhood, presented our ENT clinic complaining of right ear fluid drainage and hearing loss for the past year. Two months prior to presentation, he began to have increased fluid drainage from the right ear. Examination of the right external auditory canal showed thick, white fluid and a tympanic membrane perforation with a protruding small mass. A sample of the fluid was obtained. Culture of the right EAC fluid grew aerobic, gram-negative rods, identified as Kerstersia Gyiorum. The patient was initially treated with topical ofloxacin and topical prednisolone drops. He was seen again 4 weeks later and was noted to have persistent fluid drainage from the right ear. At this time, oral sulfamethoxazole-trimethoprim was added to his regimen.