Liu HongYan, Zhu YiFan, Huang YangYiYi, Jiang Hua
Department of Otolaryngology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.
J Med Case Rep. 2025 May 5;19(1):207. doi: 10.1186/s13256-025-05257-4.
Tuberculous otitis media is a chronic Mycobacterium tuberculosis infection of the middle ear tissues. Diseases with varied and insidious clinical features can make diagnosis difficult and delay treatment.
Here, we document a case of tuberculous otitis media in a 46-year-old ethnic Han woman that manifested as nonspecific chronic otitis media. A mastoidectomy and tympanoplasty were performed for the initial diagnosis of cholesteatoma. The histopathology of the tissue specimen revealed granuloma formation with necrosis. Staining for acid-fast bacilli and the polymerase chain reaction method for Mycobacterium tuberculosis yielded negative results. However, the chest computed tomography scan demonstrated a pulmonary miliary nodule. Next, metagenomic next-generation sequencing was applied and the Mycobacterium tuberculosis was identified. The patient recovered after receiving antituberculous treatment.
This report highlights the application of novel diagnostic tools such as metagenomic next-generation sequencing as a supplementary method for the diagnosis of tuberculous otitis media in highly suspected patients.
结核性中耳炎是中耳组织的慢性结核分枝杆菌感染。其临床特征多样且隐匿，可能导致诊断困难并延误治疗。
在此，我们记录了一例46岁汉族女性的结核性中耳炎病例，该病例最初表现为非特异性慢性中耳炎。因初步诊断为胆脂瘤而行乳突根治术和鼓室成形术。组织标本的组织病理学显示有肉芽肿形成伴坏死。抗酸杆菌染色及结核分枝杆菌聚合酶链反应检测结果均为阴性。然而，胸部计算机断层扫描显示肺部有粟粒状结节。随后，应用宏基因组下一代测序技术鉴定出结核分枝杆菌。患者接受抗结核治疗后康复。
本报告强调了宏基因组下一代测序等新型诊断工具在高度疑似结核性中耳炎患者诊断中的辅助应用。
