Chronic Tuberculous Otomastoiditis: A Case Report

Bruschini, Luca; Ciabotti, A; Berrettini, Stefano

doi:10.5152/iao.2016.2097

Cited by 13 publications

(14 citation statements)

References 9 publications

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“…Histopathology along with AFB staining of tissue removed from the middle ear cleft confirmed the diagnosis of TB in 9 cases (90%). Hence it is important to collect granulation tissue during middle ear and mastoid surgery for histopathological examination and AFB staining, in regions where TB is endemic (L Bruschini et al., 2016 ). Surgical debridement along with ATT gave good disease control in our patients.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Tuberculous otitis media –series of 10 cases

et al. 2020

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“…Diagnosis is made by direct culture of Mycobacterium tuberculosis or molecular techniques from the local discharge or a biopsy sample. In our case, after the MRI showed a mass originating in the left tympanic cavity, there was a high suspicion of tuberculous otomastoiditis [1,2] . Although otorhinolaryngological forms of GPA may be ANCA-negative, the lack of evidence of localized or systemic vasculitis raised questions about the initial diagnosis and its auto-immune origin.…”

Section: Discussionmentioning

confidence: 61%

Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind

Pedro

Meleiro

Marinho

2020

European Journal of Case Reports in Internal Medicine

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Mycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who was immediately started on immunosuppressive treatment. Years later, she developed progressive hypoacusis. Magnetic resonance imaging (MRI) revealed an extensive mass in the tympanic cavity extending to the mastoid. A biopsy of the mass was positive for Mycobacterium tuberculosis. Immunosuppressants were weaned and the patient was started on anti-tuberculous therapy with resolution of the complaints and findings. Tuberculous infections are difficult to diagnose and frequently mimic other illnesses, but in our case, we believe that an indolent tuberculous process was present from the beginning and evolved under immunosuppressive therapy.

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“…Therefore, anti-tuberculosis treatment is often delayed as a diagnosis is made only by direct smears, culture, histological and molecular biological testing and these usually require surgical sampling [8,13]. Smears of ear discharge have been found positive for AFB in 0-20% cases and cultures are positive in 5-44% of cases [14,15].…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Otitis Media with Facial Paralysis-Case Report and Review of Literature

Velankar¹

2018

OOAJ

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Tuberculous otitis media is characterised by non-specific symptoms. Its diagnosis is confirmed with histological and gene amplification tests. We present a case report of a patient presenting with an ear discharge and facial nerve paralysis who was treated with facial nerve decompression and anti-tubercular treatment. The objective of this report is to create awareness about tuberculous otitis media and that it should always be considered in the differential diagnosis of chronic otitis media.

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Chronic Tuberculous Otomastoiditis: A Case Report

Cited by 13 publications

References 9 publications

Tuberculous otitis media –series of 10 cases

Tuberculous otitis media –series of 10 cases

Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind

Tuberculous Otitis Media with Facial Paralysis-Case Report and Review of Literature

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