[The clinical manifestations and diagnostics of otitis media caused by tuberculosis].
The objective of the present study was to clarify the characteristic pathognomonic features of middle ear lesions associated with tuberculosis and the approaches to their diagnostics under the present-day conditions. The study included 11 cases (18 ears) of tuberculosis otitis media and the related lesions of the mastoid process diagnosed with the use of clinical, roentgenological, cytological, bacteriological, pathomorphological, and molecular-genetic methods (including PCR diagnostics). The primary localization of tuberculosis in the middle ear was documented in 6 patients; in 5 patients, it was associated with pulmonary involvement. Five patients presented with smoldering exudative otitis media and the remaining six ones with suppurative perforating otitis media. The tuberculous process was diagnosed with the use of various methods including clinical examination, bacteriological (9%), cytological (27.3%), pathomorphological (18%) studies, and PCR diagnostics (55%). Diagnosis was made within a period from 1 month to 1.5 years after the application of the patients for medical assistance which suggests the difficulty of verification of tuberculous etiology of the disease of the middle ear. It is concluded that the high index of suspicion in the case of smoldering middle ear pathology facilitates its early diagnostics and successful treatment.
L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
A I
AI
Kryukov
L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
E V
EV
Garov
L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
A Yu
AY
Ivoilov
L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
G B
GB
Shadrin
L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
N G
NG
Sidorina
L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152.
A S
AS
Lavrova
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D010035:Otitis Media, Suppurative / Q000175:diagnosis / Q000209:etiology / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D013506:Otologic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000209:etiology
D000995:Antitubercular Agents