Atypical mycobacteriosis in the temporal bone

Introduction Mastoiditis due to atypical mycobacteria is rare in clinical practice. It is precisely for this reason that it presents a diagnostic and therapeutic challenge. Here we show a case that was treated in our department.

Case Report A 9-year-old patient was referred for recurrent otitis media. Multiple oral antibiotic therapy was unsuccessful. During the clinical examination we saw the picture of chronic otitis media with a moist-putrid otorrhea. The cone beam CT scan showed soft-tissue formations in the epitympanic cavity. An ear surgery was performed in which was found and removed granulation tissue. In the outpatient course, there was persistent otorrhea and dehiscence of the wound. A revision operation with microbiological and immunological diagnostics followed, which initially showed no specific results. Only in the course of a further revision surgery due to the persistence of the clinical picture, atypical mycobacteria could be detected and the patient was given a 6-month specific antibiotic therapy, which led to a complete remission of the disease.

Discussion In the case of therapy-resistant mastoiditis, the cause of an infection with atypical mycobacteria should be considered. In addition to surgical rehabilitation, an essential therapeutic factor is microbiologically controlled long-term antibiotic therapy.

Publication History

Article published online:
24 May 2022