Otite média tuberculosa

Abstract

Este trabalho resulta de revisão bibliográfica desde o início do século XX sobre Otite Média Tuberculosa (O.M.T.). Aborda aspectos históricos, epidemiológicos, fisiopatológicos, clínicos, diagnósticos e de tratamento, dando ênfase à evolução dos mesmos ao longo dos anos, diante das diversas modificações ocorridas na população e na medicina. Além disso frisa a prevalência de formas de tuberculose extra-pulmonar, como a OMT, nos indivíduos HIV positivos, o que em nosso contexto atual é de extrema importância.

A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region

“…This is contrary to our findings wherein majority of the EPTB cases (91.7 %) were in the ENT region. TB lymphadenitis of the cervical region is the commonest manifestation of EPTB [2,4,[6][7][8]. In the present study too cervical TB lymphadenitis accounted for 87.4 % of cases of EPTB and 95.3 % of cases of EPTB in the ENT region.…”

Tuberculose de orelha, doença profissional?

“…1,3,4,9 It classically affects children more often than adults. 1,11 Although the pathogenesis itself is still controversial, some theories explaining middle ear tuberculosis infection have been developed, 1,3,5,[11][12][13] namely: hematogenic transmission from distant sites, for instance, in miliary tuberculosis; by direct extension from the nasopharynx through the auditory tube, with or with no primary pharyngeal infection, particularly in children in whom milk infected with Mycobacterium bovis enters directly into the middle ear by the auditory tube; by lymphatic vessels; externally, by tympanic membrane perforation; by direct extension from adjacent structures; from infection of the central nervous system; due to congenital infection (via the placenta); or during passage through the birth channel.…”

“…14 Caseous necrosis and specific granulation with epithelioid cells and giant Langerhans cells may be seen. 4,5,9,14 Radiology -initially the tympanic cavity is filled, with no signs of bone erosion; later, ossicles may be destroyed, there may be sclerosis of the mastoid cortex, middle ear and mastoid cell opacification, increased density of the mastoid cortical bone and radioluscency if there is bone resorption. 4,11 The PCR genetic analysis -the results may be obtained from biopsy material within hours.…”

“…3 Factors that have led to an increased incidence of tuberculosis in past decades include: the increased prevalence of HIV infection; an increased incidence of people living in poor social and economic conditions; increased resistance to anti-tuberculosis therapy; the development of resistant bacilli; drug dependency; diabetes; and alcoholism. [3][4][5][6][7][8] In the head and neck tuberculosis affects mostly the larynx, and to a lesser degree, the middle and external ear, the tonsils, neck lymph nodes, the pharynx, the mouth and salivary glands. 4,7,8 In the beginning of the 20th century, tuberculosis caused 3% to 5% of chronic suppurative otitis media cases; this rate decreased with the advent of anti-tuberculosis therapy.…”

“…This is due to lack of constitutional symptoms and the fact that signs and symptoms are frequently indistinguishable from nontuberculous chronic otitis media. 4,5,10,11 The purpose of this paper was to review the literature on this theme, to report four cases of tuberculous otitis media, and to describe the predisposing factors, clinical features, the diagnosis, the progression, and therapy.…”