Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind

Pedro, Bárbara and Meleiro, Marta and Marinho, António (2020) Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind. European Journal of Case Reports in Internal Medicine, 7 (3). ISSN 2284-2594

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Abstract

Mycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who was immediately started on immunosuppressive treatment. Years later, she developed progressive hypoacusis. Magnetic resonance imaging (MRI) revealed an extensive mass in the tympanic cavity extending to the mastoid. A biopsy of the mass was positive for Mycobacterium tuberculosis. Immunosuppressants were weaned and the patient was started on anti-tuberculous therapy with resolution of the complaints and findings. Tuberculous infections are difficult to diagnose and frequently mimic other illnesses, but in our case, we believe that an indolent tuberculous process was present from the beginning and evolved under immunosuppressive therapy.

Item Type: Article
Uncontrolled Keywords: Tuberculosis, immunosuppression, mastoiditis, biopsy
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Chiara D'Arpa
Date Deposited: 19 Nov 2020 10:13
Last Modified: 19 Nov 2020 10:13
URI: http://eprints.bice.rm.cnr.it/id/eprint/19934

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