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Relationship between tuberculous otomastoiditis and tuberculous meningitis

Published online by Cambridge University Press:  17 August 2007

G Sonmez ,
V Turhan ,
M G Senol ,
E Ozturk ,
H O Sildiroglu  and
H Mutlu
G Sonmez*
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
V Turhan
Affiliation:
Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
M G Senol
Affiliation:
Department of Neurology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
E Ozturk
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
H O Sildiroglu
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
H Mutlu
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
*
Address for correspondence: Dr Guner Sonmez, GATA Haydarpasa Egitim Hastanesi, 34668 Uskudar, Istanbul, Turkey. Fax: +90 216 5422808 E-mail: [email protected]
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Abstract

Objective:

The aim of this study was to determine the correlation between tuberculous meningitis and tuberculous otomastoiditis.

Materials and methods:

Meningeal involvement sites were investigated by magnetic resonance imaging in 32 patients (21 males, 11 females) who had previously been diagnosed with tuberculous meningitis. Clinical and laboratory findings and responses to anti-tuberculous treatment were evaluated, and the presence of concomitant tuberculous otomastoiditis was also investigated.

Results:

The meningeal involvement site was unilateral (in the sylvian fissure and the perimesencephalic cistern) in 28 patients (87.5 per cent), and bilateral and widespread in four patients (12.5 per cent). Tuberculous otomastoiditis was found in 11 of the patients with tuberculous meningitis (34.3 per cent). Otomastoiditis was on the same side as the meningeal involvement in nine of these 11 patients. Bilateral otomastoiditis with meningeal involvement was observed in two patients.

Conclusions:

Tuberculous meningitis is frequently accompanied by otomastoiditis, although the exact causal relationship between the two conditions is unclear. Since meningitis is a serious clinical condition, concomitant otomastoiditis generally remains unrecognised. Tuberculosis should be considered in the differential diagnosis of patients with otitis or otomastoiditis who do not respond to antibiotic therapy.

Keywords

TuberculosisMastoiditisMeningitisOtitis Media
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 9 , September 2008 , pp. 893 - 897
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Harisinghani, MG, McLoud, TC, Shepard, JA, Ko, JP, Shroff, MM, Mueller, PR. Tuberculosis from head to toe. Radiographics 2000;20:449–70CrossRefGoogle ScholarPubMed
2 Cavallin, L, Muren, C. CT findings in tuberculous otomastoiditis. A case report. Acta Radiol 2000;41:49–51CrossRefGoogle ScholarPubMed
3 Vaamonde, P, Castro, C, Garcia-Soto, N, Labella, T, Lozano, A. Tuberculous otitis media: a significant diagnostic challenge. Otolaryngol Head Neck Surg 2004;130:759–66CrossRefGoogle ScholarPubMed
4 Mutlu, H, Silit, E, Pekkafali, Z, Basekim, CC, Kantarcı, M, Kizilkaya, E. Tuberculosis meningitis: comparison of contrast enhanced T1 weighted and Flair MR imaging with magnetization transfer contrast. Rivista di Neuroradiologia 2005;18:185–90CrossRefGoogle Scholar
5 Ozates, M, Kemaloglu, S, Gurkan, F, Ozkan, U, Hosoglu, S, Simsek, MM. CT of the brain in tuberculous meningitis. A review of 289 patients. Acta Radiol 2000;41:13–17CrossRefGoogle ScholarPubMed
6 Weiner, GM, O'Connell, JE, Pahor, AL. The role of surgery in tuberculous mastoiditis: appropriate chemotherapy is not always enough. J Laryngol Otol 1997;111:752–3CrossRefGoogle ScholarPubMed
7 Mongkolrattanothai, K, Oram, R, Redleaf, M, Bova, J, Englund, JA. Tuberculous otitis media with mastoiditis and central nervous system involvement. Pediatr Infect Dis J 2003;22:453–6CrossRefGoogle ScholarPubMed
8 Awan, MS, Salahuddin, I. Tuberculous otitis media: two case reports and literature review. Ear Nose Throat J 2002;81:792–4CrossRefGoogle ScholarPubMed
9 Reid, VA, Keane, J. Images in clinical medicine. Tuberculous mastoiditis and cerebral tuberculoma. N Engl J Med 2002;5:347Google Scholar
10 Cho, YS, Lee, HS, Kim, SW, Chung, KH, Lee, DK, Koh, WJ et al. Tuberculous otitis media: a clinical and radiologic analysis of 52 patients. Laryngoscope 2006;116:921–7CrossRefGoogle ScholarPubMed
11 Saunders, NC, Albert, DM. Tuberculous mastoiditis: when is surgery indicated? Int J Pediatr Otorhinolaryngol 2002;65:59–63CrossRefGoogle ScholarPubMed
12 Pitcher, R, Thandar, MA. Bilateral tuberculous mastoiditis and facial palsy. S Afr Med J 2004;94:893–4Google ScholarPubMed
13 Chiu, NC, Pang, F, Juh, LT, Huang, CJ. Tuberculous otitis media, mastoiditis associated with meningitis: report of one case. Zhonghua Yi Xue Za Zhi (Taipei) 1992;49:131–4Google ScholarPubMed
14 Thandar, MA, Fagan, JJ, Garb, M. Extensive calvarial tuberculosis: rare complication of tuberculous mastoiditis. J Laryngol Otol 2004;118:65–8CrossRefGoogle ScholarPubMed
15 Unuvar, E, Oguz, F, Sadikoglu, B, Sidal, M, Ones, U, Tetikkurt, S. Calvarial tuberculosis. J Paediatr Child Health 1999;35:221–2CrossRefGoogle ScholarPubMed
16 Bitsori, M, Galanakis, E, Kokori, H, Amanakis, Z, Sbyrakis, S. Tuberculous mastoiditis in a child. Eur J Pediatr 1999;158:435CrossRefGoogle ScholarPubMed
17 Samuel, J, Fernandes, CM. Tuberculous mastoiditis. Ann Otol Rhinol Laryngol 1986;95:264–6CrossRefGoogle ScholarPubMed
18 Lee, ES, Chae, SW, Lim, HH, Hwang, SJ, Suh, HK. Clinical experiences with acute mastoiditis – 1988 through 1998. Ear Nose Throat J 2000;79:884–92CrossRefGoogle ScholarPubMed