Tuberculous Otitis Media

Singhania

Indian J Otolaryngol Head Neck Surg

et al. 2013

Though tuberculosis (TB) primarily affects lungs, extra pulmonary tuberculosis (EPTB) is also common, especially in high disease load areas and mainly manifests in ENT region. To study the different manifestations of tuberculosis in ENT region in terms of presentation, disease process, treatment and outcome. Records of patients diagnosed and treated for TB in the ENT region at our institute's DOTS centre for a two and half year period were analysed for presenting complaints, examination findings, diagnostic features, treatment modes and outcome. Out of 3750 cases diagnosed as TB, 230 had EPTB. 211 cases had ENT manifestations. Majority of the cases were male and in the fourth decade of life. Commonest manifestation was cervical lymphadenopathy with 201 cases. Fine needle aspiration cytology was mostly diagnostic and category I anti TB treatment (AKT) achieved cure. The six cases of TB otitis media presented with ear discharge, sometimes bloody and had varied tympanic membrane findings and facial palsy in two cases with different types and degrees of hearing loss. Diagnosis was confirmed by histology of tissue removed during surgery. Patients completed category I AKT. Hearing and facial palsy did not improve. There were three cases of TB laryngitis and one of nasal TB both of which were confirmed by tissue diagnosis and responded well to AKT. Most of the results in the present study conform to findings of other studies. High degree of suspicion is necessary to reach diagnosis. Category I AKT is effective. Some cases may require surgery.

Section: Discussionmentioning

confidence: 99%

A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region

Singhania

Indian J Otolaryngol Head Neck Surg

et al. 2013

Indian J Otolaryngol Head Neck Surg

“…The prevalence of active or inactive pulmonary tuberculosis in patients with TOM ranges from 14 to 93% [5,6]. The pathogenesis of TOM involves three major mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Otitis Media and Lupus Vulgaris of Face: An Unusual Association

Kohli

Kumar

Nibhoria

2011

Tuberculous otitis media is a rare extra-pulmonary presentation of tuberculosis. Tuberculous otitis media is usually associated with pulmonary tuberculosis or tuberculosis involving nasopharynx and oropharynx. Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis. The disease often affects the face and may be associated with nasal or nasopharyngeal tuberculosis. Lupus vulgaris associated with tuberculous otitis media is not reported in English literature. We report a case of 40 year old female patient who presented with symptoms of chronic suppurative otitis media and nonhealing skin lesion of face. The biopsy of skin lesion showed granulomatous pathology and helped us to reach a diagnosis of tuberculous otitis media.

Rev. Bras. Otorrinolaringol.

“…1,3,4,9 It classically affects children more often than adults. 1,11 Although the pathogenesis itself is still controversial, some theories explaining middle ear tuberculosis infection have been developed, 1,3,5,[11][12][13] namely: hematogenic transmission from distant sites, for instance, in miliary tuberculosis; by direct extension from the nasopharynx through the auditory tube, with or with no primary pharyngeal infection, particularly in children in whom milk infected with Mycobacterium bovis enters directly into the middle ear by the auditory tube; by lymphatic vessels; externally, by tympanic membrane perforation; by direct extension from adjacent structures; from infection of the central nervous system; due to congenital infection (via the placenta); or during passage through the birth channel.…”

Section: Review Of the Literature And The Diffe-rential Diagnosismentioning

confidence: 99%

“…8,13 The clinical picture is polymorphic and insidious, varying according to the immunological status of patients. 9 The rule is: a patient with otorrhea and evidence of active tuberculosis in any other part of the body has tuberculosis of the ear until proven otherwise.…”

Section: Review Of the Literature And The Diffe-rential Diagnosismentioning

confidence: 99%

“…8,11,14 Complications occur mostly when the diagnosis is late, and include: peripheral facial paralysis, retroauricular fistulae, labyrinthitis, meningitis, tuberculous osteomyelitis of the petrous pyramid, subperiosteal, cerebral or cerebellar abscesses, acute mastoiditis and cellulites. 4,11,12,13 Peripheral facial palsy may be present in 15 to 40% of tuberculous otitis media cases, more frequently in children. 4 The prognosis does not depend on decompression, but rather on early diagnosis and treatment.…”

Section: Review Of the Literature And The Diffe-rential Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Tuberculose de orelha, doença profissional?

Sens¹,

Almeida²,

Valle

et al. 2008

Tubercul osis is a rare cause of chronic suppurative otitis media and mastoiditis; the predisposing factors of this association, however, are not commonly described. There has been an alarming increase in the incidence of tuberculosis in Brazil, including tuberculous otitis media. These patients typically present multiple perforations of the tympanic membrane, an ear discharge, and progressive hearing loss. This diagnosis should be taken into account in patients that do not respond to routine therapy for fungal external otitis or bacterial otitis media. In this retrospective study, the authors describe four cases of patients with tuberculous otitis media. This sample consisted of two physicians, a chemical engineer and an underage child in whose family there were cases of active tuberculosis. Predisposing factors for tuberculous otitis were contact with family members that had tuberculosis, professional contact with patients and exposure to pathogenic microorganisms in airways.