Case Reports
Patient 1: A 29 year-old female with Meniere’s disease presented with
dizziness, hearing loss, nausea and vomiting. On physical examination
her pinnae appeared dark blue (Figure 1A). She ultimately underwent
endolymphatic sac decompression to treat Meniere’s disease.
Intraoperatively her temporal bone was noted to appear blue-black
(Figure 1B). Upon further investigation the patient revealed that she
had taken Minocycline for severe acne for 8 years.
Patient 2: A 44 year-old mentally disabled male presented for
precipitous hearing loss. The patient’s tympanic membranes (Figure 2A),
sclera (Figure 2B), pinnae (Figure 2C), nail beds (Figure 2D), and
gingiva (Figure 2E) were dark blue. Initially, thought to be
hemotympanum, Computerized Tomography (CT) demonstrated clear middle ear
spaces. Audiometric examination demonstrated left high-frequency
sensorineural hearing loss and right moderate to profound mixed hearing
loss. The patient’s urine darkened when oxidized (Figure 2F).