Complicated coexisting pyogenic and tuberculous otitis media affecting the temporozygomatic, infratemporal, and parotid areas: Report of a rare entity

January 24, 2013
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Abstract

We report an unusual case in which a 28-year-old woman presented with a long-standing history of ear discharge, hearing loss, facial weakness with ipsilateral facial swelling and cellulitis, a postauricular fistula, and an abscess of the temporozygomatic, infratemporal, and parotid areas. The pus stained positive for bacteria and acid-fast bacilli, and culture was positive for Proteus vulgaris and mycobacteria. Based on these findings, a diagnosis of tuberculous otitis media with complications was made. Computed tomography showed extensive destruction of the tympanic and mastoid part of the temporal bone, as well as lytic lesions in the skull. The patient was placed on antituberculosis drug therapy. Although her facial nerve palsy and hearing loss persisted, she otherwise responded well and did not require surgery.


Introduction

Chronic suppurative otitis media is a common condition in developing countries. Its overall prevalence can be attributed to a relatively high prevalence among patients of low socioeconomic status. The combined prevalence of tubotympanic and atticoantral disease is 4.1%.1 Most cases of tubercular otitis media have been reported in Africa, where the disease is endemic.

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