Tuberculosis Of Ear Research Articles

A Case of Middle Ear Tuberculosis in Childhood

A Case of Middle Ear Tuberculosis in Childhood

ТУБЕРКУЛЕЗ СРЕДНЕГО УХА

The article describes a clinical case of middle ear tuberculosis without affection of the lungs or other organs. The absence of prior TB or exposure to TB is rare and atypical for this clinical form of TB.

Extrapulmonary Tuberculosis Manifests as Middle Ear Tuberculosis: A Rare Case Report from Secondary Health Care Center at Sub-Himalayan Region

Tuberculosis of ear is a rare entity. Early diagnosis and prompt treatment can prevent many serious complications. Here we report a case of 45 year old female with middle ear tuberculosis which was cured with mastoid exploration followed by anti tubercular treatment. Keywords: Tuberculosis, TB, Extrapulmonary Tuberculosis, Middle Ear Tuberculosis, Sub-Himalayan Region

Aggressive Tuberculous Otitis Media in a Young Child

Objective: The aim of this report is to describe an aggressive case of tuberculous otitis media in a young child and emphasize that surgical intervention and histopathologic studies can be employed to immediately arrive at a definitive diagnosis.
 Methods:
 Design: Case Report
 Setting: Tertiary Government Training Hospital
 Participants: One 
 Results: This is a case of a four-year-old boy who had refractory otitis media and erosive CT scan findings, mimicking aggressive CSOM manifestations. Due to unusual intraoperative granulation tissue characteristics, it was initially considered a malignancy, necessitating surgical intervention and biopsy that resulted in a definitive diagnosis of primary middle ear tuberculosis.
 Conclusion: This case represents the more severe end of the spectrum of tuberculous otitis media and supports the recommendation that a high index of suspicion, early detection, and prompt initiation of treatment are imperative in its management, especially in children with refractory otitis media.
 Keywords: tuberculous otitis media; tuberculosis; middle ear; otitis media; suppurative otitis media

Трудности диагностики туберкулеза височной кости и среднего уха (случай из практики)

Трудности диагностики туберкулеза височной кости и среднего уха (случай из практики)

Optimization of the present-day diagnostics of tuberculosis of the upper respiratory tract and ears

This study included a total of 365 patients presenting with tuberculosis of the respiratory organs followed up based at the the Republican TB dispensary. All the patients underwent the comprehensive clinical and laboratory examination with the use of the diagnostic algorithm designed for the otorhinolaryngological examination of the patients suffering from respiratory tuberculosis. The upper respiratory tract tuberculosis was diagnosed in 46 (12.6%) of the examined patients. Laryngeal tuberculosis was documented in 44 (12.1%) patients and middle ear tuberculosis in 2 (0.5%) patients. The most informative method for the diagnostics of tuberculosis of the upper respiratory tract and the ears was a histological study that allowed to reveal more than 70% of the total number of the cases. However, this method of does not reliably confirm or exclude the diagnosis of tuberculous of the upper respiratory tract and ears in all the patients. The accurate diagnostics with the elucidation of the specific character of the pathological process is possible only on the basis of a thorough investigation and comprehensive examination of the suspected patients.

Atypical inflammation of the middle ear

The objective of the present study was to characterize the patients presenting with atypical inflammation of the middle ear and consider the currently available methods for their examination. A total of 20 patients at the age from 16 to 66 years were admitted to the Department of Ear Microsurgery during the period from 2008 and 2016 for the treatment of atypical inflammation of the middle ear. Eleven of them (18 ears) were found to have tuberculous lesions (TL) of the middle ear while the remaining 9 patients (11 ears) suffered giant cell vasculitis (GCV). All the patients underwent the general clinical and otorhinolaryngological examination, computed tomography of the temporal bones and the thoracic cavity organs, cytological, bacteriological, pathomorphological, and molecular-genetic studies including PCR diagnostics, rheumatological tests, as well as counseling by a phthisiotherapist and rheumatologist. The primary localization of TL in the middle ear was documented in 6 patients including its association with lung lesions in 5 cases. The clinical picture of the disease in 5 patients was that of smoldering exudative pathology and in 6 ones was accompanied by suppurative perforative otitis media. According to the laboratory analyses, bacteriological diagnostics proved efficient in 9% of the patients, pathomorphological and cytological diagnostics in 18% and 27.3% of the cases respectively while the effectiveness of PCR diagnostics was estimated at 55%. The diagnosis in individual patients was established within the period from 1 month to 1.5 years after they first sought medical advice in connection with complaints of the ear disease. Tuberculosis of the middle ear began to develop as exudative middle otitis that acquired the form of bilateral pathology in 4 patients. Three patients had a concomitant pulmonary disease. In 4 patuents, the diagnois of middle ear tuberculosis was established based on the presence of the specific antibodies and in 5 ones based on the results of the pathomorphological study. All the studies were carried out in duplicate. The period between the beginning of the disease and the establishment of the definitive diagnosis varied from 1 month to 1 year.

Middle ear tuberculosis - clinical case

Tuberculosis is one of the oldest pathologies that affect human population, being a significant cause of morbidity/mortality in several countries. Middleear tuberculosis is a rare pathology, often misdiagnosed because of an atipic evolution, as a result leading to severe complications. This paper presents a case of tuberculous otitis media complicated with facial nerveparalysis House Brackmann type V in a patient who underwent multiple middleear surgeries before correct diagnosis was established.

Tuberculosis of the parotid gland and the middle ear: a rare case report

Abstract Tuberculosis of parotid gland is a rare entity only about a hundred cases have been reported till date. An associated tubercular otitis media is very rare. The present case was diagnosed by montoux test and treated successfully by ATT. A 26-year old lady attended our OPD with complaints of swelling over rt. parotid area and discharge from rt. ear since 5 and 3 months respectively. clinical examination, revealed a, non tender, soft, fluctuant parotid swelling of 4×2 cm, with rt. level 1b lymphadenopathy and granulations at annulus and dull, lustureless retracted TM with discharge. FNAC of parotid and granulation biopsy revealed epitheloid and giant cells with no caseation. Z-N stain for AFB, chest radiograph, serum ACE levels were unremarkable. Montoux test was positive (20FNx0120mm) and ESR was 42 mm/hr. A CT scan showed isodense mass with hypodesne centre and rim enhancement in the rt. parotid gland and MRI on T2W images had mastoiditis and middle ear mucosal disease. The patient was advised ATT and had remarkable improvement. Parotid gland and middle ear tuberculosis is rare. FNAC and Z-N staining of the aspirate, should be routinely done. Further an AFB negative presumptive diagnosis by this method may prompt a trial of ATT which can be rewarding.

Primary mucosal tuberculosis of head and neck region: a clinicopathologic analysis of 47 cases

To study the clinicopathologic features, histologic diagnosis and differential diagnosis of primary mucosal tuberculosis (TB) in the head and neck region. Forty-seven cases of primary mucosal TB of the head and neck region were studied by hematoxylin-eosin and Ziehl-Neelsen stains. The clinical and pathologic features were analyzed with review of the literature. The patients included 26 male and 21 female, with mean age 47.1 years (range 14-84 years). There were three sinonasal TB, 19 nasopharyngeal TB, two oropharyngeal TB, 18 laryngeal TB, four middle ear TB, one salivary gland TB and one laryngeal TB complicating laryngeal cancer. The initial symptoms were nasal obstruction, mucopurulent rhinorrhea, epistaxis, snoring, hoarseness, dysphagia, odynophagia, serous otitis, hearing loss, tinnitus, and otalgia. Physical examination result was variable, from an apparently normal mucosa, to an evident mass, or a mucosa with an adenotic or swollen appearance, ulcers, leukoplakic areas, and various combinations thereof. CT and MRI findings included diffuse thickening, a soft-tissue mass, calcification within the mass and bone destruction resembling malignancy. Histologic examination showed granulomas with a central necrotic focus surrounded by epithelioid histiocytes and multinucleated Langhan's giant cells. Acid-fast bacilli were difficult to demonstrate but found in 13/45 cases. Follow-up data were available in 42 patients. Primary TB arising in the head and neck mucosa is rare. It may mimic or co-exist with other conditions. The characteristic histopathology is a granuloma with central caseous necrosis and Langhans'giant cells. Identification of acid-fast bacilli and bacteriologic culture confirm the diagnosis of mycobacterial disease.

Tuberculosis of the middle ear and nasal passage: A case report.

The following report highlights the case of a 55-year-old female with nasal and middle ear tuberculosis. The diagnosis was confirmed using imagery, histopathological biopsy reports, and Polymerase chain reaction (TB-PCR). The patient was treated with rifampicin (10mg/kg), isoniazid (5mg/kg) and pyrazinamide (25mg/kg) for 9months. No recurrence was observed after one year of follow-up examination. Both nasal tuberculosis and tuberculous otitis media are currently considered rare diseases, yet if they are evaluated rapidly, there will be a good response to therapy without the need for surgery.

Tuberculous Otitis Media with Facial Paralysis Combined with Labyrinthitis

Tuberculosis otitis media is a very rare cause of otorrhea, so that it is infrequently considered in differential diagnosis because clinical symptoms are nonspecific, and standard microbiological and histological tests for tuberculosis often give false-negative results. We present a rare case presenting as a rapidly progressive facial paralysis with severe dizziness and hearing loss on the ipsilateral side that was managed with facial nerve decompression and anti-tuberculosis therapy. The objective of this article is to create an awareness of ear tuberculosis, and to consider tuberculosis in the differential diagnosis of chronic otitis media with complications.

A Case Report of Occupational Middle Ear Tuberculosis in a Nurse

This article presents a case of a 40-year-old female patient with a right-side middle ear tuberculosis. The patient was a nurse, who had worked at the Department of Pulmology, Clinical Hospital Rijeka for 17 years. The cause was infection with Mycobacterium tuberculosis while she assisted in bronchoscopy. The patient was referred to occupational medicine (OM) for confirmation of occupational disease immediately after surgery. The disease was confirmed as occupational by the Croatian Institute for Health Insurance of Health Protection at Work.During surgery a sample was taken for microbiological analysis. We did initial and control multislice computed tomography (MSCT) and control magnetic resonance imaging (MRI) of temporal bones 6 months after the surgery. The initial MSCT showed total mastoid cell shadowing without destruction, while the control image showed almost full recovery save for a few remaining shadowed cells. Adequately taken occupational history by an OM specialist can significantly shorten the time to diagnosis of a rare occupational illness that is often manifested by non-specific symptoms.

Ear tuberculosis: Clinical and surgical treatment

Two main points are discussed in this paper: First, the changing picture of the clinical process of tuberculosis, and second, various diagnostic problems caused by extra-pulmonary forms. We have analysed a case of ear tuberculosis in a child, and drawn the following conclusions: Directed chemotherapy is the primary method of treatment, and surgical methods should be used to provide tissue for bacteriological and histopathological analysis, to enable an early diagnosis during the first stage of the disease, and in other atypical cases.

Tuberculose de l'oreille moyenne

The aim of this study was to emphasize the difficulties of diagnosing middle ear tuberculosis because of its nonspecific symptoms and to incite the physician to seek it more frequently. Six cases of middle ear tuberculosis were diagnosed within a 4-year period and included in a retrospective study. We listed two men and four women with an average age of 41 years. Two patients had a mastoidectomy with a histologic examination that enabled us to rectify the diagnosis. The medical treatment was based on a bactericidal chemotherapy. In all cases, the long-term evolution was favourable, with 11 months an average passing. The symptoms of middle ear tuberculosis are misleading. Pathologic findings are increasingly taking a more important place in the diagnosis, which the new techniques of serologic tests will surely improve.

Otorrhée chronique et hypoacousie révélant une tuberculose disséminée chez l'enfant : à propos d'un cas

Ear localization is sometimes the first symptom of tuberculosis. Case report We report a case of a teen with a chronic otitis revealing a disseminated tuberculosis. The investigations showed ear, bones and pulmonary localisations. The outcome with treatment showed a persistent hearing loss. Conclusion Middle ear tuberculosis should be suspected in patients with chronic otitis and risk factors of tuberculosis. A disseminated tuberculosis should be investigated and an early treatment is necessary to prevent hearing loss.

中耳結核を伴う上咽頭結核例

A case of epipharyngeal tuberculosis with middle ear tuberculosis is reported. A 4lyear-old female complained of left otorrhea and left facial nerve palsy. Examination of the epipharynx revealed a granular mass. A biopsy from the epipharynx showed only inflammatory changes. A smear of ear discharge and post nasal discharge showed no positive results. To facilitate diagnosis and to reduce the inflammation, we performed an exploratory tympanotomy and biopsy of the epipharynx under general anesthesia. The pathological findings were consistent with Mycobacterium tuberculosis infection. Anti-tuberculosis chemotherapy was performed for one year and the epipharynx granuloma disappeared and the facial nerve palsy was reduced. The present case suggests that it can be difficult to diagnose tuberculosis and that it is very important to consider tuberculosis in cases of intractable inflammation of the head and neck region.

Early detection of tubercular otitis media: A clinicopathological study

Four out of 80 cases admitted for ear surgery had tubercular otitis media. Associated pulmonary tuberculosis and tuberculosis cervical lymphadenitis were present in one case only. Rest three cases had primary tuberculosis of ear. All the four cases were diagnosed by histopathology. Radical mastoidectomy followd by antitubercular treatment was given in all the four cases. Post aural abscess and facial paralysis were present only in one case.In three months follow up, all the four cases had dry ear, facial paralysis recovered but hearing did not improve as tympanoplasty was not attempted in any case. There was no further deterioration of hearing after surgery in any case.

Ein Beitrag zur Klinik und Histopathologie der Mittelohrtuberkulose*

During the past few decades the clinical features of middle ear tuberculosis have changed. Hence, clinical differentiation between tuberculous and non-specific proliferative otitis media and mastoiditis is now difficult. Between 1986 and 1992 five cases of tuberculous otitis media were treated surgically in the ENT-Dept. of the University of Hamburg, representing 0.2% of all performed middle ear operations. According to our experience the therapy of choice is the open mastoid cavity with subsequent chemotherapy to avoid recurrent infections. The advantages of this procedure are proven by actual histopathological findings as well as by the analysis of historical microsections of the Wittmaack temporal bone collection: according to these findings, two different types of histopathological alterations can be differentiated.

内耳摘出術を要した中耳結核例

A case of intractable middle ear tuberculosis which required labyrinthectomy is reported.The patient is a 16-year-old boy who complained of left hearing loss, vertigo and left facial palsy. He had had middle ear operations three times in other hospitals without any improvement.The diagnosis of middle ear tuberculosis was made on the basis of the tuberculin test and cultures of aural discharge. It took one and a half years from the definite diagnosis to complete healing with combinations of chemotherapy and three operations. Because diagnosis was delayed, it was necessary to performed a labyrinthectomy.It is concluded that middle ear tuberculosis must be considered first in cases of progressive profound-deaf, facial paresis and resistant to the ordinary antibiotics because the course of this disease is rapid and irreversible.