NECROTIZING OTITIS-EXTERNA, OTITIS-MEDIA, PERIPHERAL FACIAL PARALYSIS, AND BRAIN-ABSCESS IN A THALASSEMIC CHILD AFTER ALLOGENEIC BMT

Severe infection is one of the major complications in the early and la te post-bone marrow transplantation period The authors report a thales semic child who developed necrotizing otitis; externa and otitis media , a very rare complication after bone marrow transplantation, and then peripheral facial nerve paralysis and brain abscess in the early peri od of bone marrow transplantation despite antibacterial and antifungal prophylaxis. Necrotizing otitis media is characterized by necrosis an d sloughing of considerable areas in the middle ear and adjacent tissu es and is an unusual disorder because of today's antibiotics. Granuloc ytopenia and background ear tissue exposed to previous repeated otitis media attacks may be the predisposing factors in this case. The autho rs conclude that the children with previous histories of recurrent oti tis media should be prepared and monitored very carefully during bone marrow transplantation because of the risk of necrotizing otitis media , especially in the granulocytopenic period.