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).