Tubercular otomastoiditis presenting with Citelli’s abscess
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20213296Keywords:
Tuberculosis, Temporal bone, Otomastoiditis, Citelli’s abscess, Chronic otitis mediaAbstract
Tuberculosis (TB) of the temporal bone is a rare condition. Tubercular otomastoiditis presenting with Citelli’s abscess, facial nerve palsy and extensive bone destruction is an unusual condition. As far as we know this maybe the first reported case with the above diagnosis. A 26 year old male patient presented with chronic right ear discharge, decreased hearing and right side facial nerve palsy with tender fluctuant swelling in the right post aural region approximately 10×8 cm in dimension, posterior to the mastoid tip and extending into the occipital region, almost reaching up to the midline posteriorly. High resolution computed tomography (CT) scan of temporal bone and magnetic resonance imaging (MRI) of brain was done. He underwent right side mastoid exploration and drainage of the abscess under general anaesthesia. The specimens sent for investigations revealed acid fast bacilli suggestive of Mycobacterium tuberculosis and the patient was started on anti-tubercular therapy. In all cases of long-standing chronic otitis media (COM) especially in those with complications, possibility of TB should be ruled out. High index of suspicion is needed for early diagnosis and treatment and to prevent dreaded complications in such patients.
References
Watkinson JC, Clarke RW. Scott-Brown’s otorhinolaryngology and head and neck surgery: volume 2: paediatrics, ear and skull base surgery. 8th ed. New Delhi: CRC Press; 2018.
Sebastian SK, Singhal A, Sharma A, Doloi P. Tuberculous otitis media-series of 10 cases. J Otol. 2020;15(3):95-8.
Organization WH. Global Tuberculosis Control: Epidemiology, Strategy, Financing : WHO Report 2009. World Health Organization; 2009. 315 p.
Emmett JR, Fischer ND, Biggers WP. Tuberculous mastoiditis. Laryngoscope. 1977;87(7):1157-63.
Cho YS, Lee HS, Kim SW, Chung KH, Lee DK, Koh WJ, et al. Tuberculous otitis media: a clinical and radiologic analysis of 52 patients. Laryngoscope. 2006;116(6):921-7.
Kayina TKP, Tarao MS, Nula P. Tuberculosis in North-East India: patient profile and treatment outcome of patient attending RNTCP. Int J Community Med Public Health. 2019;6(7):2856.
Meena R, Meena D, Verma P. Primary tuberculosis of the temporal bone: a rare case report. Indian J Otol. 2012;18(1):41-3.
Ramages LJ, Gertler R. Aural tuberculosis: a series of 25 patients. J Laryngol Otol. 1985;99(11):1073-80.
Gupta N, Dass A, Goel N, Tiwari S. Tuberculous otitis media leading to sequentialib bilateral facial nerve paralysis. Iran J Otorhinolaryngol. 2015;27(80):231-7.
Mądryz EB, Leczycka MW, Robert B, Krzeski A. Head and neck abscesses in complicated acute otitis media-pathways and classification. Otolaryngology. 2018;8(2):345.