Myospherulosis of the paranasal sinuses, nose and middle ear. A possible iatrogenic disease.

Sixteen cases of myospherulosis, a disease of unknown etiology previously reported only from East Africa, were found in the St. Louis metropolitan area. Although the disease in Africa occurred in the peripheral deep and superficial soft tissues, in St. Louis it involved the paranasal sinuses, nose, and middle ear. All patients had previously had surgical procedures involving the regions subsequently shown to contain the structures of myospherulosis. A common denominator in these cases was the operative use of hemostatic packing containing petrolatum-based ointments and gauze. These ointments, usually containing an antibiotic, were nonsterile. This raised the possibility that the as yet unidentified structures of myospherulosis may be introduced via these petrolatum-based substances.