Tuberculous otitis media: a significant diagnostic challenge.
OBJECTIVE
This study was undertaken to revise the diagnostic characteristics of tuberculous otitis media (TOM), a disorder that is often diagnosed late, leading to delay in specific treatment.


METHODS
Retrospective study of a longitudinal series of 10 TOM patients over a 7-year period at an institutional referral center.


RESULTS
Most patients showed intractable otorrhea, moderately severe hearing loss, and necrotic eardrums with granulation tissue and single perforations. Multiple perforations, facial palsy, and cervical adenopathies were rare (<10% of patients). CT generally showed soft tissue involvement of the middle ear without bone erosion. The most effective laboratory test microbiological culture of exudate (diagnostic efficacy 71%). Specific antibiotic treatment was effective in all cases.


CONCLUSIONS
The diagnosis of TOM remains a significant challenge for otorhinolaryngologists.


CONCLUSIONS
If there are strong clinical grounds for suspicion, standard laboratory tests for tuberculosis should be repeated even if initially negative.
Vaamonde
Pedro
P
ENT Service, University Clinical Hospital of Santiago de Compostela, Spain. pedrovaal@yahoo.com
Castro
Crisanto
C
García-Soto
Nicolas
N
Labella
Torcuato
T
Lozano
Ascensión
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001706:Biopsy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000382:microbiology / Q000473:pathology
D000995:Antitubercular Agents