[When tuberculosis makes you deaf]

Abstract

Introduction: Tuberculous otomastoiditis is a rare and serious infection that most often occurs in association with pulmonary involvement. It is easy to diagnose when the two pathologies are associated and isolated. We herein report the case of a patient initially hospitalized for Pseudomonas aeruginosa necrotising otitis externa (NOE), which delayed the diagnosis of tuberculous otomastoiditis.

Observation: The 50-year-old patient was hospitalized for NOE and concurrently presented with pulmonary tuberculosis. NOE was associated with temporal bone lysis with carotid canal involvement. Despite appropriate treatment, NOE evolution was unfavourable. Two months later, the patient underwent a mastoidectomy to evacuate a mastoid abscess. In a deep tissue sample, tuberculosis complex was detected by PCR assay. For 12 months, the patient underwent for pulmonary and osseous tuberculosis. While the clinical course was favourable but deafness occurred subsequently.

Conclusion: An association of P. aeruginosa NOE and tuberculous otomastoiditis is a highly exceptional event.

Keywords: Necrotizing otitis externa; Otite maligne externe; Otite moyenne tuberculeuse; Otomastoïdite tuberculeuse; Pseudomonas aeruginosa; Tuberculous otitis media; Tuberculous otomastoiditis.