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Revista de otorrinolaringología y cirugía de cabeza y cuello

On-line version ISSN 0718-4816


WAISSBLUTH A, Sofia et al. Tuberculous otomastoiditis: A challenging diagnosis. Rev. Otorrinolaringol. Cir. Cabeza Cuello [online]. 2019, vol.79, n.2, pp.173-178. ISSN 0718-4816.

Tuberculous otomastoiditis is an extremely rare form of extrapulmonary disease that can be easily misdiagnosed. We hereby report the case of a previously healthy 35-yearold female with bilateral tuberculous otomastoiditis associated with vertigo, bilateral mixed hearing loss, and bilateral facial nerve palsy as the initial clinical presentation. Repeated Mycobacterium tuberculosis (MTB) culture and molecular testing of otorrhea aspirates were initially negative. High-resolution temporal bone computed tomography and magnetic resonance imaging showed partial opacification of the mastoid air cells without signs of bone erosion. A mastoidotomy was performed with mastoid tissue showing chronic osteomyelitis, positivity in acid-fast staining and MTB PCR. The patient was treated with a 12 month antituberculous treatment, with complete recovery of otalgia and vertigo, and improvement in hearing levels and facial nerve palsy. In summary, clinical and imaging findings for tuberculous otomastoiditis are non-specific, hence a high degree of suspicion is required in order to diagnose and promptly treat the underlying infection.

Keywords : Tuberculosis; tuberculous otomastoiditis; chronic otitis; facial nerve palsy.

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