• Xin-Chun Chen and Chang-Ching Wei.
• Department of Pediatrics, Taichung Armed Forces General Hospital, Taichung, Taiwan.
• J Emerg Med. 2014 Feb 1;46(2):e47-50.

BackgroundThe most common cause of facial palsy is idiopathic or Bell's palsy. Although uncommon in the postantibiotic era, otomastoiditis should receive more attention as a cause of facial palsy, especially in young children. Delay of identification and treatment may result in permanent neurological sequelae.ObjectivesTo describe a 3-month-old infant eventually diagnosed with masked otomastoiditis with initial presentation of facial palsy.Case ReportWe report a case of facial palsy complicated by masked otomastoiditis in a 3-month-old male infant. The facial palsy completely recovered after parenteral antibiotics and myringotomy.ConclusionWe use this case to emphasize that otomastoiditis should be considered in the differential diagnosis of young children with facial palsy. Diagnosis may be difficult as signs and symptoms of otitis media in young children are often nonspecific and subtle, particularly in infants. Early diagnosis and careful investigation of middle ear regions should be performed to avoid permanent sequelae.Copyright © 2014 Elsevier Inc. All rights reserved.

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