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  • Title: [Tuberculous Otitis media - a rare differential diagnosis in Germany].
    Author: Teschner M, Kramer S, Donnerstag F, Länger F, Lenarz T, Schwab B.
    Journal: Laryngorhinootologie; 2008 Jul; 87(7):503-6. PubMed ID: 18688924.
    Abstract:
    A 28-year-old female patient with a migrant background presented for surgery with a suspected cholesteatoma in the left ear. The patient reported having had an aural discharge for several months; otoscopic examination revealed a runny ear, and discrete granulation tissue was seen. Pure-tone audiometry showed conduction hearing loss of 30-40 dB across all frequencies in the left ear; high-resolution computed tomography of the temporal bone revealed that the mastoid and tympanic cavity were completely obscured. The intraoperative finding showed a caseous space-occupying mass that completely filled the tympanic cavity. The suspected diagnosis of tuberculosis was corroborated by pathohistological, microbiological and molecular biological tests. Tuberculostatic therapy was initiated at a different location. Although tuberculosis of the middle ear is a rare condition in Germany, it should nevertheless be considered when making a differential diagnosis, especially in high-risk patients where cholesteatoma is suspected on clinical and radiological evidence or in patients with a chronic middle ear process.
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