Ciprofloxacin ear drops caused precipitate in ear canal in Otitis Externa patient: Case Report

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2020-07-13T18:30:18+05:30 | Updated On 13 July 2020 6:30 PM IST

USA: A recent case report describes the case of a pediatric patient who experienced ear precipitate formation following treatment of otitis externa. Stacey D Curtis, University of Florida, Gainesville, Florida, USA, and colleagues presented the case report in the journal BMJ Case Reports.

The case in question is of a 13-year-old female patient who was presented with inflamed, red, and swollen external ear canal. She was diagnosed with otitis externa and subsequently treated with topical ciprofloxacin/dexamethasone.

After completing the course of therapy, the patient's pain, and discomfort resolved. But she then immediately began experiencing itchiness, loss of hearing, and the feeling of something present in the ear. Close examination of the patient's ear revealed the development of precipitate formation in her ear canal from the pharmacological treatment.

Visual examination revealed a cast of the tympanic membrane due to precipitate (measuring approximately 1.2cm in length) being stuck to the cerumen inside the patient's ear. The doctors then performed liquid chromatography with tandem mass spectrometry and confirmed that the substance was formed due to the precipitation of ciprofloxacin/dexamethasone. After removal of the precipitate, the patient's symptoms resolved and her hearing returned.

"This case report investigated a probable topical ciprofloxacin/dexamethasone-induced ear precipitate formation in the ear canal, which, subsequently, was successfully removed from the patient's ear canal," wrote the authors.

"We hypothesize that ciprofloxacin may chelate with multivalent cations found in cerumen, causing the precipitate to adhere to the cerumen, resulting in a cast on the patient's eardrum. Patients being treated with this medication should be warned of this possibility," concluded the authors.

The case report, "Ciprofloxacin/dexamethasone precipitate formation in the ear canal of a paediatric patient," is published in the journal BMJ Case Reports.

DOI: http://dx.doi.org/10.1136/bcr-2020-234290

otitis externaBMJ Case Reportear precipitate

Source : BMJ Case Reports

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751