title: A case of chronic otitis media caused by Mycobacterium abscessus.
abstract: Although it appears very uncommon in adult COM, Mycobacterium abscessus should be considered as a possible cause of a chronically draining ear. Multi-antibiotic chemotherapy including high-dose clarithromycin can effectively treat adult COM cased by M. abscessus. The first case report of adult chronic otitis media (COM) caused by M. abscessus is described here. A 61-year-old woman presented persistent otorrhea for 2 months, despite treatment with standard antimicrobial drugs. Physical examination revealed a small perforation of the tympanic membrane and edematous middle ear mucosa. Mycobacterial cultures and PCR yielded non-tuberculous mycobacteria (NTM); M. abscessus. Intravenous panipenem/betamipron and amikacin and oral clarithromycin were administered for 36 days. Computed tomography of the temporal bone showed improved aeration in the tympanic cavity, but soft tissue shadow remained unchanged in the mastoid 31 days after starting medication. She therefore underwent tympano-mastoidectomy at 36 days. At surgery, inflammation remained in the middle ear, and edematous pale mucosal tissue was noted around the stapes and ossicular chain. Histopathologic examination showed inflammation and granulation tissue, but no caseating necrosis or acid-fast bacilli. After surgery the symptoms resolved and remained well without evidence of infection recurrence 12 months after the operation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Ito
authors.forename: Miyako
authors.initials: M
authors.lastname: Hatano
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents