Cochlear implant infection in a teenager with CHARGE syndrome: a case report

Pasteurella multocida is a gram-negative coccobacillus commonly found in the oral flora of many animals, most commonly in cats and implicated in zoonotic infections, commonly cellulitis secondary to cat bites and scratches. Here we describe a teenager with CHARGE syndrome who developed an infection of her cochlear implant secondary to P multocida. An 18-year-old female with CHARGE syndrome developed headache, ear pain and cellulitis at the site of her cochlear implant and was found to have osteomyelitis and transient bacteremia secondary to P. multocida . She had extensive diagnostic work-up that included CT temporal bone with contrast, blood culture and wound culture leading to both surgical and medical management, including removal of her cochlear implant and four weeks of antibiotic therapy. Her course was complicated by facial nerve palsy requiring steroids. Exposure history included numerous excoriations from her new kitten at home. This case highlights the importance of obtaining thorough exposure history as part of the evaluation of any pediatric patient with headache, ear pain and cellulitis with complicating factors such as presence of cochlear implant in order to include zoonotic infections on the differential diagnosis. Additionally, this case highlights the importance of a multidisciplinary team for care of patients with complex medical and surgical histories.