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Case Reports
. 2018 Jan 17:2018:bcr2017221797.
doi: 10.1136/bcr-2017-221797.

Congenital tuberculosis presenting as otorrhoea in a preterm infant

Jose Carlos Aldana-Aguirre  1   2 , Hamdy El-Hakim  1   3 , Ernest Phillipos  1   2 , Marc-Antoine Landry  1   2
Affiliations
Case Reports

Congenital tuberculosis presenting as otorrhoea in a preterm infant

Jose Carlos Aldana-Aguirre et al. BMJ Case Rep. .

Abstract

A premature infant of 25 weeks' gestational age presented at 8 weeks after birth with otorrhoea from the left ear. Following a course of topical and systemic antibiotics, the patient deteriorated developing facial nerve paralysis and cervical lymphadenitis. Contrast-enhanced CT and MRI of the head showed a destructive process of the left temporal bone. These findings prompted the clinicians to send swabs from the purulent discharge from the ear for acid-fast bacilli stain. Furthermore, surgical exploration and debridement were undertaken. Cultures from ear discharge and biopsy-taken during surgical procedure-revealed the presence of Mycobacterium tuberculosis complex. The patient developed necrotizing otitis media, left temporal bone osteomyelitis and cervical lymphadenitis. The infant's mother was found to have an endometrial biopsy positive for M. tuberculosis suggesting the diagnosis of congenital tuberculosis.

Keywords: neonatal and paediatric intensive care; neonatal health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
CT temporal bones: image demonstrates complete opacification of the left middle ear (single arrow) with inflammatory changes that surrounds and occludes the ipsilateral external auditory canal and ipsilateral temporal bone erosion (triple head arrow).
Figure 2
Figure 2
Coronal brain STIR MRI: image shows the overall appearance of the soft tissue neck lesion in keeping with infection with either necrotic lymph nodes or abscess (white arrow). STIR, short T1 inversion recovery.
See this image and copyright information in PMC

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