title: Tuberculous otitis media: a significant diagnostic challenge.
abstract: 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.
authors.affiliation: ENT Service, University Clinical Hospital of Santiago de Compostela, Spain. pedrovaal@yahoo.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Vaamonde
authors.forename: Crisanto
authors.initials: C
authors.lastname: Castro
authors.forename: Nicolas
authors.initials: N
authors.lastname: García-Soto
authors.forename: Torcuato
authors.initials: T
authors.lastname: Labella
authors.forename: Ascensión
authors.initials: A
authors.lastname: Lozano
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents