Otomastoiditis caused by non-tuberculous mycobacteria: report of 16 cases, 3 with infection intracranially

Lundman, Lars; Edvardsson, Henrik; Ängeby, Kristian

doi:10.1017/s0022215115001309

Cited by 13 publications

(9 citation statements)

References 38 publications

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“…All four attained culture negativity while on treatment, and no recurrences have been noted after a mean of 14 months (range, 8 to 19 months; Table 2) of follow-up after treatment. This compares favorably to a larger series of 12 children with M. abscessus otomastoiditis; 2 (17%) experienced treatment failure after treatment with widely varying regimens and various numbers and extents of surgical interventions (9).…”

Section: Treatment and Outcomesmentioning

confidence: 47%

Successful Systemic and Topical Treatment of Mycobacterium abscessus Otomastoiditis

Wijk

Waterval

Aerde

et al. 2019

Antimicrob Agents Chemother

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Mycobacterium abscessus is an extensively drug-resistant opportunistic pathogen that can cause chronic otomastoiditis. There are no evidence-based treatment regimens for this severe infection. We treated four children with M. abscessus otomastoiditis with a structured regimen of topical imipenem and tigecycline, intravenous imipenem and tigecycline, and oral clofazimine and azithromycin and adjunctive surgery. This structured approach led to cure, with 1 year of follow-up after treatment. Adverse events were frequent, mostly caused by tigecycline.

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Section: Treatment and Outcomesmentioning

confidence: 47%

Successful Systemic and Topical Treatment of Mycobacterium abscessus Otomastoiditis

Wijk

Waterval

Aerde

et al. 2019

Antimicrob Agents Chemother

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“…The key study characteristics are summarised in supplementary table 1. Two patients had a relapse six months after curation (Lundman et al, 2015, Ferguson et al, 1996. These relapses were treated as new patients while assessing treatment-associated data (n = 87).…”

Section: Study Selection Characteristics and Bias Assessmentmentioning

confidence: 99%

“…In contrast to current guidelines, some articles mention conservative treatment without surgery to be favourable when there is only limited disease and the medical condition of the patient is good (Lundman et al, 2015, Sedillot-Daniel., 2020. Among the included patients who did not receive surgery, curation was only difficult (> one year of treatment) in the two patients with the presence of local disease spread on conservative treatment (Yeh et al, 2015, Vijayananthan et al, 2008.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Where earlier published research states to combine surgery, even repeated, and systemic antibiotics for 6 months minimum (Van Ingen., 2010, Lundman et al, 2015, Yeh et al, 2015, more recent research suggests adding local treatment to this multi-modal approach (Sedillot-Daniel et al, 2020, Van Wijk et al, 2020. These intensive multimodal treatment regimens commonly result in several complaints and adverse events frequently resulting in cessation of therapy.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics and an evaluation of predictors for a favourable outcome of Mycobacterium abscessus otomastoiditis: a systematic review and meta-analysis of individual participant data

Manders

Leow

Aerde

et al. 2022

International Journal of Infectious Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Nontuberculous mycobacteria (NTM) are commonly found in the environment, including in soil, water, plants, and animal excretions [4,5]. These bacteria can even be detected in healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

Mycobacterial Infection in Recalcitrant Otomastoiditis: A Case Series and Literature Review

Tsai,

Lan,

Mao

et al. 2023

JCM

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Otomastoiditis caused by mycobacterial infections is uncommon and recalcitrant. Its clinical presentations, sometimes similar to those of common chronic suppurative otitis media, make diagnosis difficult. This retrospective study analyzed the clinical features, treatment course, and therapeutic outcomes of patients with mycobacterial otomastoiditis. The cases of six patients diagnosed with mycobacterial otomastoiditis or suspected mycobacterial infection between January 2007 and January 2019 in a single tertiary medical center in Taiwan were investigated. Information about predisposing factors, clinical features, culture reports, histopathology, treatment course, and outcomes were collected and analyzed. Relevant literature available in English was also reviewed. One patient was infected with tuberculous mycobacteria, two with suspected tuberculous mycobacteria, and three with nontuberculous mycobacteria. All six patients responded poorly to empiric antibiotic therapy, and diagnosis was not possible at their previous clinics. Five patients underwent tympanomastoidectomies; one was administered antimycobacterial medication without undergoing surgery. Mycobacterial infection was confirmed from a tissue culture or from the histopathology of the specimen, but in two patients, no definitive evidence of tuberculosis was found. Antimycobacterial medication was administered based on clinical suspicion, and improvement was noted. With appropriate therapy, all patients recovered, and no sequelae were observed after treatment. If empiric antibiotic therapy cannot achieve acceptable results, atypical infections, such as mycobacteria, should be considered. Antimycobacterial medication could be administered under clinical suspicion, serving as a diagnosis ex juvantibus. Surgical intervention might help reduce the bacterial load and obtain specimens for accurate diagnosis, but this may be unnecessary if appropriate antimycobacterial medication results in improvement. Early diagnosis and treatment can prevent complications in patients with recalcitrant otomastoiditis.

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Otomastoiditis caused by non-tuberculous mycobacteria: report of 16 cases, 3 with infection intracranially

Abstract: Non-tuberculous otomastoiditis is a severe ear disease with challenging considerations, and should be treated aggressively in order to avoid morbidity.

Cited by 13 publications

References 38 publications

Successful Systemic and Topical Treatment of Mycobacterium abscessus Otomastoiditis

Successful Systemic and Topical Treatment of Mycobacterium abscessus Otomastoiditis

Clinical characteristics and an evaluation of predictors for a favourable outcome of Mycobacterium abscessus otomastoiditis: a systematic review and meta-analysis of individual participant data

Mycobacterial Infection in Recalcitrant Otomastoiditis: A Case Series and Literature Review

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