Tuberkulöse Otitis media - Eine seltene Differenzialdiagnose in Deutschland

Teschner, Matthias; Kramer, S.; Donnerstag, Frank; Lenarz, T; Schwab, Burkard

doi:10.1055/s-2007-995511

Cited by 3 publications

(7 citation statements)

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“…Se obtuvieron cultivos positivos para M. tuberculosis com- [2,[6][7][8][9][10][11]15,16,[18][19][20][21][22][23][24][25]27], todos ellos retrospectivos. El total de pacientes fue de 43 con edades comprendidas en el rango: 3 meses-87 años, siendo en su mayoría mujeres (n=30, 69,76%) (Tabla 1).…”

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“…El total de pacientes fue de 43 con edades comprendidas en el rango: 3 meses-87 años, siendo en su mayoría mujeres (n=30, 69,76%) (Tabla 1). El área geográfica de los artículos seleccionados incluye los países: Alemania (8%) [5,6], Croacia (4%) [2], España (20%) [3,[7][8][9]26], Francia (8%) [10,11], Grecia (8%) [12,13], Hungría (4%) [14], Italia (16%) [15][16][17][18], Países Bajos (4%) [19], Portugal (4%) [20], Rumania (4%) [21] y UK (20%) [22][23][24][25]27].…”

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“…Mediante el uso de técnicas de amplificación de ácidos nucleicos (TAAN) se obtuvieron resultados positivos para 18 (41,86%) pacientes, 16 (37,21%) a través de biopsias y 2 (4,65%) de exudados (Tabla 2). De ellos, 12 (27,91%) pacientes tuvieron también cultivos positivos [5,8,[12][13][14]26], para el resto o solo se especifica la realización de TAAN (n=4; 9,3%) [6,15,16,20] o el cultivo fue negativo (n=2; 4,65%) [18,22]. En 4 del total de los artículos revisados [2,3,10,21], debido a que solo mencionan la realización de la tinción de bacilos ácido-alcohol resistentes y no aportan datos de cultivo o antibiograma, presuponemos que el diagnóstico se realizó desde anatomía patológica.…”

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Tuberculous otitis media: A case presentation and review of european literature

Aguilera-Franco,

Franco-Acosta,

Yépez-Naranjo

et al. 2023

Rev Esp Quimioter

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Tuberculous otitis media (TOM) is a rare affectation in our environment that represents a challenge in its diagnosis due to the non-specific symptoms that it usually presents. This paper presents our experience in the diagnosis of a case of TOM in a 66-year-old woman with hearing loss and chronic otorrhea of more than 6 months of evolution that did not respond to conventional treatments. In addition, a review of the cases published in the last 20 years (2000-2022) in countries of the European Union (EU) is carried out. The most common symptoms were otorrhea (n=43; 100%), hearing loss (n=37; 86.05%), eardrum perforation (n=19; 44.18%), facial paralysis (n=12, 27,91%) and ear pain (n=13; 30,23%). The most used sample for diagnosis was the biopsy obtained by mastoidectomy (n=34; 79.06%). All patients were given antituberculous therapy for a mean duration of 8.11 months (range, 6-12 months). The most frequent aftereffect was hearing loss (n=28; 65.12%). TOM should be included in the differential diagnosis of chronic suppurative otitis, since early diagnosis and treatment reduce the probability of suffering irreversible sequelae.

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Tuberculous otitis media: A case presentation and review of european literature

Aguilera-Franco,

Franco-Acosta,

Yépez-Naranjo

et al. 2023

Rev Esp Quimioter

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“…TB is primarily a pulmonary disease, although extra‐pulmonary presentations exist including, pericardial, central nervous system, genitourinary, abdominal, bone, joint, lymph node and skin disease presentations 3 . The most common presentation of TB affecting the head and neck region is that of TB otitis media 4–7 . Cases of TB affecting the temporomandibular joint 8 , orbit 9 , skull 10,11 , oral cavity 12,13 , parotid gland 14 and zygoma 15 are also reported in the literature.…”

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confidence: 99%

Fronto‐temporal swelling: case report of an unusual presentation of primary, extra‐pulmonary tuberculous infection

Zafar

Keshani

2010

Oral Surgery

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Tuberculosis (TB) is an infectious disease caused by slow growing, acid fast, aerobic mycobacterium and has become the leading cause of death from a single infectious disease. Primary extra‐pulmonary TB lesions may arise as swellings in the head and neck, and can pose challenges of diagnosis and management to healthcare professionals. We present an unusual case of primary extra‐pulmonary TB manifesting as a fluctuant swelling of the fronto‐temporal region of the head and discuss value of special tests, such as fine needle aspiration cytology, microbiology and histopathology, with reference to previous case reports of TB in the head and neck.

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“…Infection was associated with acute conductive hearing loss and purulent otorrhea and confirmed by the presence of anti-Rhabditis antibodies in the patient's serum. The differential diagnosis consisted of a broad range of bacterial and fungal infectious agents and cholesteatoma (14,15,16). The concomitant finding of A. feacalis in swab cultures of the ear canal was regarded as an accidental finding.…”

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Outer Ear Canal Infection with Rhabditis sp. Nematodes in a Human

et al. 2014

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Here we report the first human case of an outer ear canal infection with a free-living nematode of the genus Rhabditis. Otomicroscopy revealed viable worms in the outer ear canal of a patient suffering from chronic otorrhea and hearing loss. The nematode was identified by microscopy and internal transcribed spacer (ITS)-PCR. CASE REPORTA 37-year-old male presented with purulent otorrhea from both ears for 8 weeks in a tertiary care center. Additionally, he reported of mild hearing loss since the beginning of symptomatic disease. Both otorrhea and hearing loss were more pronounced for the right ear, on which the patient had undergone mastoidectomy 3 years earlier due to chronic otitis media. The patient reported no other underlying disease or recent travel history, owned a pet dog as well as a pet cat, and had been working in an industrial agriculture company. Macroscopic inspection and visualization by otomicroscopy of the outer ear canal confirmed otorrhea and revealed tympanostomy tubes and a retraction of the tympanic membranes on both sides. The tuning fork test according to Weber lateralized left, the tuning fork test according to Rinne was bilaterally negative, and no spontaneous nystagmus as a sign of disturbance of the vestibular system was detected. Pure-tone audiometry revealed a conductive hearing loss on both sides in combination with a mild sensorineural hearing loss of 20 dB hearing level (HL) in the middle frequencies on the right side. No other local or systemic signs of infection such as fever or enlarged cervical lymph nodes were detected.Because a chronic bacterial otitis media infection was suspected, local antibiotic ear drops containing ciprofloxacin (3 mg per ml) were prescribed. Bacterial swab cultures from the outer ear canal obtained prior to antibiotic therapy detected bacteria of the normal skin flora (coagulase-negative staphylococci, nonhemolytic streptococci, and Corynebacterium spp.) as well as Alcaligenes faecalis, none of which are typically associated with otitis media. At that time, surgery was considered in the event of persistent clinical symptoms to exclude cholesteatoma. Cholesteatoma represents a benign proliferation of keratinizing squamous epithelium, which can lead to local tissue destruction and secondary chronic infection.In a follow-up physical examination 4 weeks later, no regression of clinical symptoms was noted. Surprisingly, otomicroscopy of both outer ear canals under 25-fold magnification revealed a large number of viable, moving worm-like organisms (Fig. 1, arrow). Both external ear canals were rinsed with saline solution, and the lavage fluid was submitted for further parasitological examination. The patient was treated with repeated topical application of ethanol (dequaliniumchlorid [0.04 g], glycerin anhydricum, ethanol [90%] aa ad 20 g) twice a day. No blood tests for leukocytosis or eosinophilia were performed due to the absence of clinical symptoms of a general infection. Microscopy of the unstained lavage fluid revealed high numbers of viable, 500-to-...

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Tuberkulöse Otitis media - Eine seltene Differenzialdiagnose in Deutschland

Cited by 3 publications

References 8 publications

Tuberculous otitis media: A case presentation and review of european literature

Tuberculous otitis media: A case presentation and review of european literature

Fronto‐temporal swelling: case report of an unusual presentation of primary, extra‐pulmonary tuberculous infection

Outer Ear Canal Infection with Rhabditis sp. Nematodes in a Human

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