[Tuberculous Otitis media - a rare differential diagnosis in Germany].
A 28-year-old female patient with a migrant background presented for surgery with a suspected cholesteatoma in the left ear. The patient reported having had an aural discharge for several months; otoscopic examination revealed a runny ear, and discrete granulation tissue was seen. Pure-tone audiometry showed conduction hearing loss of 30-40 dB across all frequencies in the left ear; high-resolution computed tomography of the temporal bone revealed that the mastoid and tympanic cavity were completely obscured. The intraoperative finding showed a caseous space-occupying mass that completely filled the tympanic cavity. The suspected diagnosis of tuberculosis was corroborated by pathohistological, microbiological and molecular biological tests. Tuberculostatic therapy was initiated at a different location. Although tuberculosis of the middle ear is a rare condition in Germany, it should nevertheless be considered when making a differential diagnosis, especially in high-risk patients where cholesteatoma is suspected on clinical and radiological evidence or in patients with a chronic middle ear process.
Teschner
M
M
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Medizinische Hochschule Hannover. teschner.magnus@mh-hannover.de
Kramer
S
S
Donnerstag
F
F
Länger
F
F
Lenarz
Th
T
Schwab
B
B
D000328:Adult; D003937:Diagnosis, Differential; D004432:Ear, Middle / Q000473:pathology / Q000601:surgery; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D010033:Otitis Media / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D038781:Otoscopy; D036542:Tomography, Spiral Computed; D014376:Tuberculosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery