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[结核性中耳炎:病例报告及欧洲文献综述]

[Tuberculous otitis media: A case presentation and review of european literature].

作者信息

Aguilera-Franco M, Franco-Acosta A, Yépez-Naranjo A F, Rodríguez-Granger J, Sampedro A, Navarro-Mari J M

机构信息

María Aguilera Franco, Servicio de Microbiología y Parasitología Clínica. Hospital Universitario Virgen de las Nieves. Granada. Spaun.

出版信息

Rev Esp Quimioter. 2023 Oct;36(5):519-525. doi: 10.37201/req/011.2023. Epub 2023 Jun 2.

Abstract

Tuberculous otitis media (TOM) is a rare affectation in our environment that represents a challenge in its diagnosis due to the non-specific symptoms that it usually presents. This paper presents our experience in the diagnosis of a case of TOM in a 66-year-old woman with hearing loss and chronic otorrhea of more than 6 months of evolution that did not respond to conventional treatments. In addition, a review of the cases published in the last 20 years (2000-2022) in countries of the European Union (EU) is carried out. The most common symptoms were otorrhea (n=43; 100%), hearing loss (n=37; 86.05%), eardrum perforation (n=19; 44.18%), facial paralysis (n=12, 27,91%) and ear pain (n=13; 30,23%). The most used sample for diagnosis was the biopsy obtained by mastoidectomy (n=34; 79.06%). All patients were given antituberculous therapy for a mean duration of 8.11 months (range, 6-12 months). The most frequent aftereffect was hearing loss (n=28; 65.12%). TOM should be included in the differential diagnosis of chronic suppurative otitis, since early diagnosis and treatment reduce the probability of suffering irreversible sequelae.

摘要

结核性中耳炎(TOM)在我们所处的环境中是一种罕见疾病,因其通常呈现的非特异性症状,在诊断上具有挑战性。本文介绍了我们对一名66岁女性TOM病例的诊断经验,该患者有听力损失及超过6个月病程的慢性耳漏,对常规治疗无反应。此外,还对欧盟国家在过去20年(2000 - 2022年)发表的病例进行了回顾。最常见的症状为耳漏(n = 43;100%)、听力损失(n = 37;86.05%)、鼓膜穿孔(n = 19;44.18%)、面瘫(n = 12;27.91%)和耳痛(n = 13;30.23%)。诊断最常用的样本是通过乳突切除术获取的活检组织(n = 34;79.06%)。所有患者均接受了抗结核治疗,平均疗程为8.11个月(范围6 - 12个月)。最常见的后遗症是听力损失(n = 28;65.12%)。TOM应纳入慢性化脓性中耳炎的鉴别诊断,因为早期诊断和治疗可降低发生不可逆后遗症的概率。

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本文引用的文献

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Tuberculosis of the middle ear: A systematic review.中耳结核:系统评价。
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Bilateral Tuberculous Otitis: A Furtive Middle Ear Infection.双侧结核性中耳炎:隐匿性中耳感染。
J Craniofac Surg. 2020 Sep;31(6):e552-e553. doi: 10.1097/SCS.0000000000006478.
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Chronic Tuberculous Otomastoiditis: A Case Report.慢性结核性中耳乳突炎:一例报告
J Int Adv Otol. 2016 Aug;12(2):219-221. doi: 10.5152/iao.2016.2097.
9
Tuberculosis as a differential diagnosis in cases of persistent otorrhea refractory to standard antimicrobial treatment.
Infect Dis (Lond). 2017 Mar;49(3):223-224. doi: 10.1080/23744235.2016.1201724. Epub 2016 Jul 7.

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