Relationship between tuberculous otomastoiditis and tuberculous meningitis.
OBJECTIVE
The aim of this study was to determine the correlation between tuberculous meningitis and tuberculous otomastoiditis.


METHODS
Meningeal involvement sites were investigated by magnetic resonance imaging in 32 patients (21 males, 11 females) who had previously been diagnosed with tuberculous meningitis. Clinical and laboratory findings and responses to anti-tuberculous treatment were evaluated, and the presence of concomitant tuberculous otomastoiditis was also investigated.


RESULTS
The meningeal involvement site was unilateral (in the sylvian fissure and the perimesencephalic cistern) in 28 patients (87.5 per cent), and bilateral and widespread in four patients (12.5 per cent). Tuberculous otomastoiditis was found in 11 of the patients with tuberculous meningitis (34.3 per cent). Otomastoiditis was on the same side as the meningeal involvement in nine of these 11 patients. Bilateral otomastoiditis with meningeal involvement was observed in two patients.


CONCLUSIONS
Tuberculous meningitis is frequently accompanied by otomastoiditis, although the exact causal relationship between the two conditions is unclear. Since meningitis is a serious clinical condition, concomitant otomastoiditis generally remains unrecognised. Tuberculosis should be considered in the differential diagnosis of patients with otitis or otomastoiditis who do not respond to antibiotic therapy.
Sonmez
G
G
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey. gunersonmez@hotmail.com
Turhan
V
V
Senol
M G
MG
Ozturk
E
E
Sildiroglu
H O
HO
Mutlu
H
H
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008417:Mastoiditis / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D014394:Tuberculosis, Osteoarticular / Q000209:etiology / Q000473:pathology*
D000995:Antitubercular Agents