Tuberculous Otitis Media With Cerebral Venous Thrombosis: A Rare and Challenging Diagnostic Case

Tuberculous otitis media is an uncommon cause of chronic suppurative infection affecting the middle ear and mastoid. Unfortunately, the signs and symptoms of tuberculous otitis media are very similar to those of non-tuberculous otitis media, which can make early diagnosis challenging. It is crucial...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-02, Vol.16 (2), p.e54391
Main Authors: Alharthi, Ayidh, Alghamdi, Ghayda A, Alghamdi, Banan S, Alghamdi, Ghadi S, Alzahrani, Najla K
Format: Article
Language:English
Subjects:
Analgesics
Antibiotics
Audiometry
Case reports
Ear diseases
Eardrum
Emergency medical care
Headaches
Hearing loss
Medical diagnosis
Neck pain
Neurology
Otolaryngology
Pediatrics
Sinuses
Teenagers
Thrombosis
Tinnitus
Tuberculosis
Veins & arteries
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Summary:Tuberculous otitis media is an uncommon cause of chronic suppurative infection affecting the middle ear and mastoid. Unfortunately, the signs and symptoms of tuberculous otitis media are very similar to those of non-tuberculous otitis media, which can make early diagnosis challenging. It is crucial to diagnose and treat the condition early to prevent damage to the ear and potential complications involving the central nervous system. We present a case of a 13-year-old Saudi girl who presented with a two-week history of headaches associated with photophobia. She had been complaining of ophthalmalgia, otalgia, and decreased hearing for one year. Physical examination revealed bilateral optic disc swelling with grade 3-4 papilledema, middle ear effusion, and bilateral hearing loss. CT scan showed sinusitis with right otomastoiditis and right petro-mastoiditis. MRI with magnetic resonance venography (MRV) revealed cerebral venous thrombosis. Tuberculosis screening by polymerase chain reaction (PCR) of a sputum sample and right ear effusion sample taken by tympanocentesis was done and it came back positive three weeks later. She was started on anti-tuberculous treatment, with clinical improvement observed over six months. Multiple factors contributing to the delay in diagnosis possibly included the lack of awareness about this ailment among doctors, leading to a low suspicion rate, variable clinical presentation, and diagnostic pitfalls.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.54391