Bilateral tuberculous otitis media: An unique presentation

Bhatkar, Dhiraj; Utpat, Ketaki; Desai, Unnati; Joshi, Jyotsna M

doi:10.1016/j.ijtb.2016.10.005

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…In contrast to our study, there have been reported cases where the initial presentation includes painless purulent ottorhea accompanied the progressive deafness [10,11].…”

Section: Discussioncontrasting

confidence: 99%

Tuberculous Otitis Media With Cerebral Venous Thrombosis: A Rare and Challenging Diagnostic Case

Alharthi,

Alghamdi,

Alghamdi

et al. 2024

Cureus

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Tuberculous otitis media is an uncommon cause of chronic suppurative infection affecting the middle ear and mastoid. Unfortunately, the signs and symptoms of tuberculous otitis media are very similar to those of non-tuberculous otitis media, which can make early diagnosis challenging. It is crucial to diagnose and treat the condition early to prevent damage to the ear and potential complications involving the central nervous system. We present a case of a 13-year-old Saudi girl who presented with a two-week history of headaches associated with photophobia. She had been complaining of ophthalmalgia, otalgia, and decreased hearing for one year. Physical examination revealed bilateral optic disc swelling with grade 3-4 papilledema, middle ear effusion, and bilateral hearing loss. CT scan showed sinusitis with right otomastoiditis and right petro-mastoiditis. MRI with magnetic resonance venography (MRV) revealed cerebral venous thrombosis. Tuberculosis screening by polymerase chain reaction (PCR) of a sputum sample and right ear effusion sample taken by tympanocentesis was done and it came back positive three weeks later. She was started on anti-tuberculous treatment, with clinical improvement observed over six months. Multiple factors contributing to the delay in diagnosis possibly included the lack of awareness about this ailment among doctors, leading to a low suspicion rate, variable clinical presentation, and diagnostic pitfalls.

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“…In contrast to our study, there have been reported cases where the initial presentation includes painless purulent ottorhea accompanied the progressive deafness [10,11].…”

Section: Discussioncontrasting

confidence: 99%

Tuberculous Otitis Media With Cerebral Venous Thrombosis: A Rare and Challenging Diagnostic Case

Alharthi,

Alghamdi,

Alghamdi

et al. 2024

Cureus

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“…Tuberculosis (TB) is a major health problem in the developing world and India accounts for ¼ th of the global TB burden (2.79 million) (C Carvalho et al., 2018 ; TB India report 2017 ). Tuberculous otitis media (TOM) is a relatively rare disease and accounts for 4% of head and neck TB ( S Jesic et el 2009 ; Saltzman SJ et al., 1971 ) and is characterized by indolent and heterogeneous presentations ( Bhatkar D et al., 2017 ). It often presents as otitis media not responding to conventional management ( Saltzman SJ et al., 1971 ).…”

Section: Introductionmentioning

confidence: 99%

Tuberculous otitis media –series of 10 cases

et al. 2020

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Background Tuberculosis (TB) of the middle ear cleft (MEC) is a rare extra-pulmonary manifestation. Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult. Objectives To study the clinical presentations, complications and effective diagnostic modalities in tuberculosis of middle ear cleft. Methods We retrospectively studied 10 patients diagnosed with chronic otitis media, unresponsive to 2 months conventional treatment. Pure tone audiogram, High resolution computed tomography (HRCT) of temporal bone, and AFB staining of ear discharge were done. All patients underwent mastoid surgery. AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done. Results Clinical findings were mastoid swelling, facial palsy and post-aural fistula 3,4 & 2 patients respectively. All patients had persistent ear discharge and three had vertigo. Hearing loss was of moderate conductive type in five, sensorineural type in three and mixed type in two. HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases. Diagnosis of TB was confirmed either by (a) demonstration of AFB in ear discharge (4 patients)/tissue removed during surgery (4 patients) or (b) by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC (8 patients). Conclusion Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas. Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.

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“…8 It not only develops severe clinical manifestations, such as bilateral facial palsy or meningitis, 9 , 10 but also presents as minor symptoms, such as conductive hearing loss with otorrhea. 11 Although the number of cases is too small to elucidate the general characteristics of bilateral TOM, it should be recognized that TOM can appear in a bilateral form.…”

Section: Discussionmentioning

confidence: 99%

Primary Bilateral Tuberculous Otitis Media After Kidney Transplantation: A Case Report

2023

Int Adv Otol

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We report a case of primary bilateral tuberculous otitis media in a patient who underwent kidney transplantation. This case presents unusual clinical features and histopathology from those of classical tuberculous otitis media. A 75-year-old woman presented at the clinic with purulent ear discharge and hearing loss in both ears. She had undergone kidney transplantation 6 years prior and had been taking immunosuppressant medications. Otoscopic examination and imaging studies suggested acute otitis media, which was irresponsive to antibiotics. The patient underwent surgery to eradicate the disease, and histopathologic examination revealed multifocal granulomas with Langhans giant cells without caseous changes. Ziehl–Neelsen staining and polymerase chain reaction confirmed the diagnosis of tuberculous otitis media. While tuberculous otitis media is a very rare manifestation of extrapulmonary tuberculosis, this case is more noteworthy in that it occurred as a primary infection rather than as a reactivation of a prior infection. In addition, it did not show the classical triad of clinical manifestations, which occurred bilaterally, and its histopathology was different from those of classical tuberculous otitis media. This case presents a new clinical variation in tuberculous otitis media.

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Bilateral tuberculous otitis media: An unique presentation

Cited by 7 publications

References 6 publications

Tuberculous Otitis Media With Cerebral Venous Thrombosis: A Rare and Challenging Diagnostic Case

Tuberculous Otitis Media With Cerebral Venous Thrombosis: A Rare and Challenging Diagnostic Case

Tuberculous otitis media –series of 10 cases

Primary Bilateral Tuberculous Otitis Media After Kidney Transplantation: A Case Report

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