Otomastoiditis Caused byMycobacterium abscessus, the Netherlands

Jakko Van Ingen,Dick Van Soolingen,Richard Dekhuijzen,Piet Mirck,Frank Looijmans,Martin Boeree

doi:10.3201/eid1601.090473

Abstract

To the Editor: Nontuberculous mycobacteria (NTM) are increasingly recognized as human pathogens (1). Otomastoiditis is a rare extrapulmonary NTM disease type first described in 1976; Mycobacterium chelonae–M. abscessus group bacteria, which are rapidly growing NTM, are the most frequent causative agents and the disease mostly affects children (1–3). In the Netherlands, M. chelonae–M. abscessus group isolates have been reported from the otologic samples of an average of 2 patients annually since 2006, as compared to 6 patients in the preceding 10 years. This emergence is not a likely result of improved laboratory facilities or awareness in clinicians because liquid culture and molecular identification techniques predate the rise in notification and Dutch guidelines advise against performing cultures for chronic otorrhea.

Highlights

We identified 10 patients from the national reference laboratory database with otologic samples yielding M. chelonae–M. abscessus group bacteria during January 1995–June 2007
All patients had a history of ear infections and tympanostomy tube placement, previously associated with Nontuberculous mycobacteria (NTM) disease [7]
Otorrhea unresponsive to antimicrobial drug therapy should raise a clinical suspicion of NTM otomastoiditis [3], especially in patients with bone destruction visible on computed tomography (CT) images

Summary

Introduction

7. Biagini P, Dussol B, Touinssi M, Brunet P, Picard C, Moal V, et al Human parvovirus 4 in kidney transplant patients, France. Otomastoiditis Caused by Mycobacterium abscessus, the Netherlands Otomastoiditis is a rare extrapulmonary NTM disease type first described in 1976; Mycobacterium chelonae–M. abscessus group bacteria, which are rapidly growing NTM, are the most frequent causative agents and the disease mostly affects children [1,2,3].

Results

Conclusion