title: Otomastoiditis caused by non-tuberculous mycobacteria: report of 16 cases, 3 with infection intracranially.
abstract: OBJECTIVE
  To analyse the clinical presentation, treatment and outcome in patients diagnosed with otomastoiditis caused by non-tuberculous mycobacteria.
  
  
  METHODS
  A retrospective case review of 16 patients diagnosed with otomastoiditis caused by non-tuberculous mycobacteria from 2000 to 2012 was conducted in a hospital and tertiary referral centre in Sweden. The main outcome measures were microbiology findings, and surgical and medical interventions and outcomes. In addition, the relevant literature was reviewed.
  
  
  RESULTS
  In three patients with otomastoiditis, the disease had spread intracranially. The bacteriological findings revealed Mycobacterium abscessus (n = 12), Mycobacterium fortuitum (n = 2) and Mycobacterium avium complex (n = 2). Surgical treatment was undertaken in all but three patients, including exploration of the temporal lobe in one patient. Systemic antibiotic treatment was given to all but one patient. Eight patients healed completely. Eight patients developed hearing loss. Two patients had relapse of the mycobacterial infection several months after the antibiotic treatment had been discontinued.
  
  
  CONCLUSIONS
  Non-tuberculous otomastoiditis is a severe ear disease with challenging considerations, and should be treated aggressively in order to avoid morbidity.
authors.affiliation: Department of OtorhinolaryngologyCentral Hospital,Karlstad,Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Lundman
authors.affiliation: Department of Pathology,Central Hospital,Karlstad,Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Edvardsson
authors.affiliation: Department of Clinical Microbiology,Karolinska Institutet,Karolinska University Hospital,Stockholm,Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Ängeby
mesh_terms: D000293:Adolescent; D001922:Brain Abscess / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000382:microbiology* / Q000601:surgery*; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology* / Q000601:surgery*; D015269:Mycobacterium avium Complex; D019907:Mycobacterium fortuitum; D010033:Otitis Media / Q000382:microbiology* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Brain Abscess; Mastoiditis; Nontuberculous Mycobacteria; Otitis Media