Chapter 16 : Tuberculous Otomastoiditis

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Tuberculous otitis media and tuberculous mastoiditis occur together as a single disease process and are referred to as tuberculous otomastoiditis. Most of the medical literature on tuberculous otomastoiditis is from Europe and Asia, where the disease is more prevalent. The chapter discusses pathogenesis and pathology of tuberculous otomastoiditis. Tuberculous otomastoiditis may be masked by suprainfection with other bacteria as well as by systemic antituberculous therapy. The diagnosis of tuberculous otomastoiditis is considered confirmed by culture of from the local discharge or biopsy sample. Once the diagnosis of tuberculous otomastoiditis is made, the combined talents of the primary care physician, an ear, nose, and throat surgeon, and an infectious disease specialist are required for optimum therapy. Isoniazid plus rifampin is the preferred antituberculous therapy, with pyrazinamide added for the first 2 months. Ethambutol is also usually given until resistant is ruled out. In addition to obtaining tissue for diagnosis, the surgeon may have a role in therapy by removing a nidus of infected debris. Complications mandating surgical approach include facial nerve paralysis, subperiosteal abscess, labyrinthitis, persistent postauricular fistula, and extension of infection into the central nervous system. After therapy is completed, reconstructive procedures may improve hearing in certain patients.

Citation: Pankey G. 2011. Tuberculous Otomastoiditis, p 266-268. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch16
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Table 1.

Frequencies of signs and symptoms in patients with tuberculous otomastoiditis

Citation: Pankey G. 2011. Tuberculous Otomastoiditis, p 266-268. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817138.ch16

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