Abstract

A male infant presented with reduced oral intake, low-grade fever and postauricular erythema. Clinical examination revealed a soft, tender swelling posteroinferior to the mastoid tip with a dull tympanic membrane on otoscopy. Cross-sectional imaging did not show any evidence of middle ear infection or mastoiditis. However, there was minimal change in clinical status despite trialling various intravenous antibiotics. One week after admission, a thin, white foreign body self-extruded from the upper part of the postauricular skin, recognised by the child’s parents as a feather from their sofa cushion. The suspected mechanism was the penetration of the feather into the skin when the child was lying on the sofa. While incredibly rare, soft tissue foreign bodies should be considered in paediatric patients with postauricular swelling not responding to antibiotics.