Analysis of cerebrospinal fluid (CSF) collectedfrom the cerebello-medullary cistern revealed amarked mixed cell pleocytosis (655 cells/lL, reportedRI, 0–3 cells/lL1) consisting of 71% nondegenerateneutrophils, 22% macrophages, and 7% lymphocytes,including reactive forms, with an increased total protein(165 mg/dL, reported RI, <30 mg/dL1). An otoscopicexamination demonstrated a large amount ofdebris and a large, solid white mass in the horizontalear canal of the left ear (Figure 2). Several biopsieswere obtained and submitted for histopathologic
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