Abstract
Necrosis of tympanic membrane (TM) can be due to infections, drugs, radiation, and foreign body. Strain of group A Streptococcus is associated with acute otitis media or in immunocompromised individuals resulting in TM necrosis. Gangrene of lower limb has been described, but the selective loss of TM due to emboli is an uncommon finding. A 62-year-old female presented with sudden behavioral changes and irrelevant talk. After 2 days, she noticed a discharge from left ear. There was perforation of left TM in posterior superior and inferior quadrant with areas of the black patch around the perforation suggesting a loss of blood supply. Patient was recently detected retrovirus positive with multiple lung shadows. Patient is not on any anti-retroviral medications or other medications. The discharge started 2 days after an episode of left middle cerebral artery infarct due to emboli with no previous history of ear symptoms. Culture of discharge showed no growth. This suggests that TM might have gone for gangrene due to emboli affecting deep auricular artery branch or posterior tympanic branch, which is a branch of the stylomastoid artery.
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