Temporal Bone Infection Caused by Atypical Mycobacterium: Case Report and Review of the Literature

Abstract

Nontuberculous mycobacteriosis should be suspected in immunosuppressed patients with intractable middle ear granulations. Cultural and histologic examinations are the mainstay for diagnosis. Long-standing multiantibiotic therapy together with aggressive surgery should be considered as appropriate management.

Mycobacterium abscessus, an Uncommon Cause of Chronic Otitis Media

“…2,6-8, 12 We cannot exclude that NTM infection in our patient developed as a superinfection resulting from preexistent otitis media with otorrhea. This could also be the case, in accordance with Redaelli de Zinis et al, 2 in patients with NTM otologic infection previously described in the literature.…”

“…Since the description of the first case in 1976, only 31 well-documented cases of middle ear infections caused by NTM have been reported. [1][2][3] Originally, NTM were divided into 4 groups using the Runyon classification, based on growth rate and pigment production. 4 However, in recent years more accurate speciesspecific identification by means of molecular techniques are available.…”

“…5 Due to the increase of immunosuppressive conditions, the incidence of NTM infections has also increased. 2 A relatively common NTM infection is cervical lymphadenitis. 1,2,6,7 We present a case of chronic otitis media with otorrhea caused by Mycobacterium abscessus, which has been scarcely reported.…”

“…2 A relatively common NTM infection is cervical lymphadenitis. 1,2,6,7 We present a case of chronic otitis media with otorrhea caused by Mycobacterium abscessus, which has been scarcely reported. [6][7][8] This case illustrates the importance of including NTM infection in the differential diagnosis of unresolving chronic otitis media because of the difference in treatment with normal otitis media and tuberculous otitis media.…”

Gradenigo Syndrome Caused by Nontuberculous Mycobacteria

“…Other possible sources of such an infection include exposure to contaminated water and transmission via the eustachian tube [Flint et al, 1999;Moerman et al, 1993;Sethi et al, 2005;TerKonda et al, 1995]. No evidence of human-to-human or animal-to-human transmission exists [Flint et al, 1999;Griffith et al, 2007;Medjahed et al, 2010;Muller et al, 2006;Redaelli de Zinis et al, 2003;Sugimoto et al, 2010;TerKonda et al, 1995]. An outbreak of 17 cases of otomastoiditis caused by M. chelonae was attributed to inadequate instrument sterilization [Lowry et al, 1988].…”