Tubercular otomastoiditis presenting with Citelli’s abscess

Abijeet Bhatia, Manu C.B., Suvamoy Chakraborty, Lham Dorjee


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.


Tuberculosis, Temporal bone, Otomastoiditis, Citelli’s abscess, Chronic otitis media

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