Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine and Pharmacy of Fes, Hassan II University Hospital, University Sidi Mohamed Ben Abdellah, Fes, Morocco.
Pan Afr Med J. 2024 Jul 12;48:100. doi: 10.11604/pamj.2024.48.100.44240. eCollection 2024.
Tuberculosis is a major public health problem in Morocco and most of the developing countries but tuberculous otomastoiditis is quite rare. Here we report a case where a seven-year-old patient had chronic right otomastoiditis and retro-auricular fistula, whose specificity is its persistence after prolonged unsuccessful medical and surgical therapy for more than 2 months, and its complication by homolateral sigmoid sinus thrombosis. Computed Tomography (CT) scan of temporal bones showed complete destruction of right mastoid cells and a hypodense complement in the right middle ear. A right drainage through the retro auricular fistula with mastoid bone biopsy confirmed the tuberculous otomastoiditis diagnosis. The clinical and radiological outcome was favorable after anti-tuberculosis treatment for 6 months. Tuberculosis otomastoiditis is well described in the literature. However, its very low incidence often impedes consideration when faced with these latent infections. This is more so the case when concomitant pulmonary symptoms are absent. Thus, the importance of such publications is a reminder to think beyond the frequent diagnosis and prevent serious complications due to delayed treatment.
结核病是摩洛哥和大多数发展中国家的一个主要公共卫生问题，但结核性耳乳突炎相当罕见。在这里，我们报告了一例七岁患者患有慢性右侧耳乳突炎和耳后瘘管，其特殊性在于经过 2 个多月的长期不成功的药物和手术治疗后仍持续存在，并并发同侧乙状窦血栓形成。颞骨的计算机断层扫描 (CT) 显示右侧乳突细胞完全破坏，右侧中耳呈低密影。通过耳后瘘管进行右侧引流并进行乳突骨活检证实了结核性耳乳突炎的诊断。经过 6 个月的抗结核治疗，临床和放射学结果良好。结核性耳乳突炎在文献中有详细描述。然而，由于这些潜伏感染的发病率非常低，因此在遇到这些感染时往往不会考虑到它。如果没有同时出现肺部症状，情况更是如此。因此，此类出版物的重要性在于提醒人们超越常见的诊断，并防止因治疗延误而导致严重并发症。
