title: Diagnostic challenges in tuberculous otitis media.
abstract: OBJECTIVE
  To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases.
  
  
  METHODS
  We report four cases of tuberculous otitis media with different clinical presentations, encountered between 1998 and 2002. None of the cases showed improvement with local or systemic antibiotics. The diagnosis, complications and management of these cases are discussed.
  
  
  CONCLUSIONS
  A high index of clinical suspicion of tuberculous otitis media is required in patients who do not respond to standard antibiotic therapy for (nontuberculous) chronic middle-ear infection. Early diagnosis and treatment of tuberculous otitis media is important to avoid irreversible complications, surgical intervention and propagation of the disease.
authors.affiliation: ORL Department, Faculty of Medicine, University Malaysia Sarawak, Kuching, Sarawak, Malaysia. ingptang@yahoo.com
authors.forename: I P
authors.initials: IP
authors.lastname: Tang
authors.forename: N
authors.initials: N
authors.lastname: Prepageran
authors.forename: C A
authors.initials: CA
authors.lastname: Ong
authors.forename: P
authors.initials: P
authors.lastname: Puraviappan
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D001301:Audiometry, Pure-Tone; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004433:Earache / Q000209:etiology; D005158:Facial Paralysis / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006097:Granulation Tissue / Q000382:microbiology; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000601:surgery; D010035:Otitis Media, Suppurative / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011859:Radiography; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy; D018058:Tympanic Membrane Perforation / Q000209:etiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents