Parálisis facial secundaria a tuberculosis de oído medio: a propósito de un caso

Abstract

Introduction: Tuberculosis is a re-emerging health problem driven by multiple risk factors, highlighting immunosuppression in HIV patients. Objectives: to show a middle ear tuberculosis atypical presentation. Case report: A 40 year old patient consulted with clinical features compatible diagnosed with tuberculous otitis media, who evolves to complicated acute otitis media associated with House-Brackmann grade III (H-B) facial paralysis. For the previous motive it’s decided, under local anesthesia, the insertion of transtimpanic drainage associated with ciprofloxacin and oral corticosteroid. Posteriorly, exists a torpid evolution with worsening of the facial function to a H-B VI and vestibular features. Computerized Tomography informs complete occupation of the tympanic cavity, antrum and mastoid air cells by inflammatory tissuecompatible with non-coalescing otomastoiditis. For these means, its consider hospitalization, and during her process fever with yellow expectoration is objected and also a torax radiography compatible with tuberculous cavernoma, not present in previous studies. Inside the battery of analytical requested, baciloscopy is performed, isolating Mycobacterium Tuberculosis Complex. Anti-tuberculous scheme was initiated with Rifampin, Isoniazid, Pyrazinamide and Ethambutol. The patient presented favorable clinical response both pulmonary and otologic. Conclusion: otomastoiditis secondary to tuberculosis is a infrequent pathology and its heterogeneous clinical features, as in this case, can difficult its diagnosis confirmation so it must be taken into account in acute otitis media that does not respond adequately to standard antibiotic therapy.