Tuberculous Otitis Media—A Rare Entity or a Missed Diagnosis

D S Deenadayal,Bashetty Naveen Kumar,K Lakshmi Sameeri,Vyshanavi Bommakanti

doi:10.4236/ijohns.2016.52011

D S Deenadayal, Bashetty Naveen Kumar + Show 2 more

Open Access

https://doi.org/10.4236/ijohns.2016.52011

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Abstract

Objective: The aim of the study is to look for indicators of Tuberculous Otitis Media in all cases of chronic suppurative otitis media. Study Design: This is a retrospective study. Setting: This study was conducted in a tertiary care centre. Subjects and Methods: Detected cases of tuberculous otitis media (TBOM) cases studied retrospectively from January 2011 to December 2013 were included in the study. Investigations for tuberculosis were considered in the cases showing suspicious pale granulation tissue in the external auditory canal and middle ear and also in cases showing exuberant pale granulation tissue during mastoid surgery where Zeihl Nielson staining, histopathology, molecular genetic study was done. Cases showing positive result were included in the study. Results: During the study period 751 cases of CSOM were seen in outpatient room of which 18 cases of TBOM were diagnosed. Three patients were diagnosed preoperatively and 181 underwent surgery of which 15 cases were diagnosed positive, from the tissue obtained during the procedure. Direct smear was positive in four cases, concentration techniques in seven cases. Line probe assay was taken as diagnostic in all the cases. None of the cases were positive on histopathology. Conclusion: Tuberculous otitis media is often missed as the classical features are not seen in all cases of TBOM. The absence of these should not stop the clinician from diagnosing the disease. Suspicious tissue should therefore be tested properly to avoid missing the diagnosis and to prevent any complications.

Highlights

Tuberculosis is a chronic granulomatous disease, caused by Mycobacterium tuberculosis-characterized byHow to cite this paper: Deenadayal, D.S., Kumar, B.N., Bommakanti, V. and Sameeri, K.L. (2016) Tuberculous Otitis Media— A Rare Entity or a Missed Diagnosis
Low prevalence of tuberculous otitis media (TBOM), scarcity of literature and knowledge, varied clinical features from silent mastoiditis to intracranial complications have often resulted in disease being a “missed diagnosis”
During the study period 751 cases of CSOM were seen in outpatient room of which 18 cases of TBOM were diagnosed

Summary

Introduction

Tuberculosis is a chronic granulomatous disease, caused by Mycobacterium tuberculosis-characterized byHow to cite this paper: Deenadayal, D.S., Kumar, B.N., Bommakanti, V. and Sameeri, K.L. (2016) Tuberculous Otitis Media— A Rare Entity or a Missed Diagnosis. (2016) Tuberculous Otitis Media— A Rare Entity or a Missed Diagnosis. Resurgence of this disease noted in 1990s [1] is being attributed to multi drug resistance, increase in population living in poor socioeconomic conditions (overcrowding & poor nutrition) and increase in the incidence of HIV. Tuberculous affecting the middle ear is very rare [2]. It accounts for less than 1% of cases of chronic suppurative otitis media [3]. Low prevalence of tuberculous otitis media (TBOM), scarcity of literature and knowledge, varied clinical features from silent mastoiditis to intracranial complications have often resulted in disease being a “missed diagnosis”. The diagnostic utility of various tests in diagnosing tuberculosis is variable, making it even more difficult to identify cases with tuberculosis

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