Sequelae of Rapid Growing Mycobacteria Otomastoiditis in a Child

Mycobacterium fortuitum otitis media: Diagnostic and therapeutic dilemma

“…isoniazid and rifampicin). [4,6,7,10] Our case was similar to these cases as it was managed by antitubercular drugs with satisfactory results.…”

“…[10] This case was a 9-year-old female, who underwent mastoid exploration two times and she also developed meningitis and subdural empyema. She was treated with rifampicin and clindamycin initially, then with doxycyclin and meropenem along with hyperbaric oxygen.…”

“…[4][5][6][7][8] Two more related cases were found, one with M. fortuitum and M. chelonei complex [9] and the other where it could not be made out whether the organism was M. fortuitum or Mycobacterium peregrinum. [10] Out of these seven cases, five had a history of use of ventilation tubes (a proposed risk factor for otic infection due to mycobacteria). [11] The earliest reported case occurred in a 63-year-old man with mastoiditis complicated by a sub-periosteal abscess at the mastoidectomy site.…”

Nontuberculous mycobacterial osteomyelitis

“…Many slow-growing NTM species have demonstrated the ability to cause NTM osteomyelitis, including M. avium-intracellulare complex (MAC) [ 3 , 8–48 ], M. ulcerans [ 49–51 ], M. marinum [ 52–57 ], M. kansasii [ 9 , 33 , 36 , 58–63 ], M. xenopi [ 64–66 ], M. gordonae [ 67 ], M. haemophilium [ 33 , 68 , 69 ], M. scrofulaceum [ 45 , 70 ], M. szulgai [ 71–74 ], M. longobardum [ 75 ], and M. flavescens [ 76 ]. Among the rapidly growing mycobacteria, osteomyelitis can be caused by M. abscessus [ 3 , 77–81 ], M. fortuitum [ 82–94 ], M. chelonae [ 5 , 25 , 83 , 95–104 ], M. smegmatis [ 105 ], M. peregrinum [ 82 ], and M. thermoresistibile [ 106 ]. Some authors have argued that the otomastoiditis attributed to M. fortuitum or M. chelonae was actually caused by M. abscessus [ 107 ], though this disagreement is actually a taxonomic issue.…”

“…Multiple bone loci can be infected by NTM through direct inoculation during surgery or via insertion of a contaminated prosthesis, for example, osteomyelitis in the sternum caused by cardiac surgery [ 91 ], otomastoiditis by myringotomy tube insertion [ 17 , 25 , 82 , 96 , 107 , 112 ], and osteomyelitis of the mandible by dental treatment [ 77 ]. In addition to nosocomial infections, NTM osteomyelitis can be caused by trauma, fracture or animal bites during activities such as gardening, farming, fish-keeping, playing in sand pits, and swimming [ 5 , 6 , 51 , 95 ].…”