Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T10:37:39.328Z Has data issue: false hasContentIssue false
  • English
  • Français

Otomastoiditis caused by non-tuberculous mycobacteria: report of 16 cases, 3 with infection intracranially

Published online by Cambridge University Press:  08 July 2015

L Lundman ,
H Edvardsson  and
K Ängeby
L Lundman*
Affiliation:
Department of OtorhinolaryngologyCentral Hospital, Karlstad, Sweden
H Edvardsson
Affiliation:
Department of Pathology, Central Hospital, Karlstad, Sweden
K Ängeby
Affiliation:
Department of Clinical Microbiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden Department of Microbiology, University of the West Indies, Kingston, Jamaica
*
Address for correspondence: Dr Lars Lundman, Department of Otorhinolaryngology, Central Hospital, SE-651 85 Karlstad, Sweden Fax: +46 542 16428 E-mail: lars.lundman@liv.se
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To analyse the clinical presentation, treatment and outcome in patients diagnosed with otomastoiditis caused by non-tuberculous mycobacteria.

Methods:

A retrospective case review of 16 patients diagnosed with otomastoiditis caused by non-tuberculous mycobacteria from 2000 to 2012 was conducted in a hospital and tertiary referral centre in Sweden. The main outcome measures were microbiology findings, and surgical and medical interventions and outcomes. In addition, the relevant literature was reviewed.

Results:

In three patients with otomastoiditis, the disease had spread intracranially. The bacteriological findings revealed Mycobacterium abscessus (n = 12), Mycobacterium fortuitum (n = 2) and Mycobacterium avium complex (n = 2). Surgical treatment was undertaken in all but three patients, including exploration of the temporal lobe in one patient. Systemic antibiotic treatment was given to all but one patient. Eight patients healed completely. Eight patients developed hearing loss. Two patients had relapse of the mycobacterial infection several months after the antibiotic treatment had been discontinued.

Conclusion:

Non-tuberculous otomastoiditis is a severe ear disease with challenging considerations, and should be treated aggressively in order to avoid morbidity.

Keywords

Otitis MediaMastoiditisNontuberculous MycobacteriaBrain Abscess
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 7 , July 2015 , pp. 644 - 655
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Austin, WK, Lockey, MW. Mycobacterium fortuitum mastoiditis. Arch Otolaryngol 1976;102:558–60CrossRefGoogle ScholarPubMed
2Avery, RK, Eavey, RD, Della Torre, T, Ramos, D, Pasternack, MS. Bilateral otitis media and mastoiditis caused by a highly resistant strain of Mycobacterium chelonae. Pediatr Infect Dis J 1996;15:1037–40CrossRefGoogle ScholarPubMed
3Dalovisio, JR, Pankey, GA, Wallace, RJ, Jones, DB. Clinical usefulness of amikacin and doxycycline in the treatment of infection due to Mycobacterium fortuitum and Mycobacterium chelonei. Rev Infect Dis 1981;3:1068–74CrossRefGoogle ScholarPubMed
4de Juan, Martín F, Bouthelier Moreno, M, Fernández Liesa, R, Lezcano Carrera, MA. Mycobacterium avium otomastoiditis [in Spanish]. An Esp Pediatr 1996;45:649–50Google Scholar
5Ferguson, PJ, Saulsbury, FT. Successful treatment of chronic Mycobacterium abscessus otitis media with clarithromycin. Pediatr Infect Dis J 1996;15:384–5CrossRefGoogle ScholarPubMed
6Flint, D, Mahadevan, M, Gunn, R, Brown, S. Nontuberculous mycobacterial otomastoiditis in children: four cases and a literature review. Int J Pediatr Otorhinolaryngol 1999;51:121–7CrossRefGoogle ScholarPubMed
7Franklin, DJ, Starke, JR, Brady, MT, Brown, BA, Wallace, RJ. Chronic otitis media after tympanostomy tube placement caused by Mycobacterium abscessus: a new clinical entity? Am J Otol 1994;15:313–20Google ScholarPubMed
8Hsiao, C-H, Liu, C-M, Hsueh, P-R. Clinicopathological and microbiological characteristics of mycobacterial otitis media in a medical center, 2000 to 2009. J Infect 2011;62:243–6CrossRefGoogle Scholar
9Kinsella, JP, Grossman, M, Black, S. Otomastoiditis caused by Mycobacterium avium-intracellulare. Pediatr Infect Dis 1986;5:704–6CrossRefGoogle ScholarPubMed
10Lee, M-R, Tsai, H-Y, Cheng, A, Liu, C-Y, Huang, Y-T, Liao, C-H et al. Otitis media and otomastoiditis caused by Mycobacterium massiliense (Mycobacterium abscessus subsp. bolletii). J Clin Microbiol 2012;50:3754–6CrossRefGoogle ScholarPubMed
11Liening, DA, Plemmons, RE, Fair, KP, Butler, WP, McAllister, CK, Davis, MG. Mycobacterium fortuitum otitis media. Otolaryngol Head Neck Surg 1997;117:S131–3CrossRefGoogle ScholarPubMed
12Linmans, JJ, Stokroos, RJ, Linssen, CFM. Mycobacterium abscessus, an uncommon cause of chronic otitis media: a case report and literature review. Arch Otolaryngol Head Neck Surg 2008;134:1004–6CrossRefGoogle ScholarPubMed
13Lowry, PW, Jarvis, WR, Oberle, AD, Bland, LA, Silberman, R, Bocchini, JA et al. Mycobacterium chelonae causing otitis media in an ear-nose-and-throat practice. N Engl J Med 1988;319:978–82CrossRefGoogle Scholar
14McAvoy, MJ, Carron, MA, Poulik, J, Altinok, D, Belenky, W. Sequelae of rapid growing mycobacteria otomastoiditis in a child. Arch Otolaryngol Head Neck Surg 2009;135:602–4CrossRefGoogle ScholarPubMed
15Moerman, M, Dierick, J, Mestdagh, J, Boedts, D, Van Cauwenberge, P. Mastoiditis caused by atypical mycobacteria. Int J Pediatr Otorhinolaryngol 1993;28:69–76CrossRefGoogle ScholarPubMed
16Molloy, J, Shandilya, M, Mahesh, B, McShane, D, El Nazir, B. One to make the diagnosis. A case of non tuberculous mycobacterial mastoiditis in a nine year old female. Ir Med J 2008;101:123–4Google Scholar
17Muller, B, Kemper, J, Hartwig, NG, Mooi-Kokenberg, EA, van Altena, R, Versteegh, FG. Mycobacterium avium intracellulare otomastoiditis: case report and literature review. Eur J Clin Microbiol Infect Dis 2006;25:723–7CrossRefGoogle ScholarPubMed
18Neitch, SM, Sydnor, JB, Schleupner, CJ. Mycobacterium fortuitum as a cause of mastoiditis and wound infection. Arch Otolaryngol 1982;108:11–14CrossRefGoogle ScholarPubMed
19Nylén, O, Alestig, K, Fasth, A, Gustavii, N, Olofsson, J, Renvall, U et al. Infections of the ear with nontuberculous mycobacteria in three children. Pediatr Infect Dis J 1994;13:653–6CrossRefGoogle ScholarPubMed
20Plemmons, RM, McAllister, CK, Liening, DA, Garces, MC. Otitis media and mastoiditis due to Mycobacterium fortuitum: case report, review of four cases, and a cautionary note. Clin Infect Dis 1996;22:1105–6CrossRefGoogle Scholar
21Redaelli de Zinis, LO, Tironi, A, Nassif, N, Ghizzardi, D. Temporal bone infection caused by atypical mycobacterium: case report and review of the literature. Otol Neurotol 2003;24:843–9CrossRefGoogle ScholarPubMed
22Stewart, MG, Troendle-Atkins, J, Starke, JR, Coker, NJ. Nontuberculous mycobacterial mastoiditis. Arch Otolaryngol Head Neck Surg 1995;121:225–8CrossRefGoogle ScholarPubMed
23Sugimoto, H, Ito, M, Hatano, M, Nakanishi, Y, Maruyama, Y, Yoshizaki, T. A case of chronic otitis media caused by Mycobacterium abscessus. Auris Nasus Larynx 2010;37:636–9CrossRefGoogle ScholarPubMed
24Sungkanuparph, S, Sathapatayavongs, B, Pracharktam, R. Infections with rapidly growing mycobacteria: report of 20 cases. Int J Infect Dis 2003;7:198–205CrossRefGoogle ScholarPubMed
25TerKonda, RP, Levine, SC, Duvall, AJGiebink, GS. 3rd, Atypical mycobacterial otomastoiditis. Laryngoscope 1995;105:1275–8CrossRefGoogle ScholarPubMed
26Ticca, F, Comparcola, D, Graziani, MC, Lancella, L, Marcella, P, Nicolsi, L et al. Otomastoiditis caused by Mycobacterium avium: a case report [in Italian]. Infez Med 1997;5:114–17Google ScholarPubMed
27Trupiano, JK, Prayson, RA. Mycobacterium avium intracellulare otitis media. Ann Diagn Pathol 2001;5:350–3CrossRefGoogle ScholarPubMed
28Van Aarem, A, Muytjens, HL, Smits, MM, Cremers, CW. Recurrent therapy resistant mastoiditis by Mycobacterium cheilonae abscessus, a nontuberculous mycobacterium. Int J Pediatr Otorhinolaryngol 1998;43:61–72CrossRefGoogle ScholarPubMed
29Van Ingen, J, Looiijmans, F, Piet, M, Richard, D, Martin, B, van Solingen, D. Otomastoiditis caused by Mycobacterium abscessus, The Netherlands. Emerg Infect Dis 2010;16:166–7CrossRefGoogle ScholarPubMed
30Vreede, RW, Kruyt, JM, Nijhuis-Heddes, JM, Sastrowijoto, SH. Recurrent otitis media and mastoiditis due to atypical mycobacteria [in Dutch]. Ned Tijdschr Geneeskd 2002;146:518–20Google ScholarPubMed
31Wardrop, PA, Pillsbury, HC. Mycobacterium avium acute mastoiditis. Arch Otolaryngol 1984;110:686–7CrossRefGoogle ScholarPubMed
32Wu, K-C, Shu, M-T, Chen, B-N. Otomastoiditis with acute left facial nerve paralysis caused by Mycobacterium chelonae. Ear Nose Throat J 2011;90:E18–22CrossRefGoogle ScholarPubMed
33Falkinham, JO. Surrounded by mycobacteria: nontuberculous mycobacteria in the human environment. J Appl Microbiol 2009;107:356–67CrossRefGoogle ScholarPubMed
34Hale, MJ. Mycobacterial infection: a histopathological chameleon. Curr Diagn Pathol 2000;6:93–102CrossRefGoogle Scholar
35Tichenor, WS, Thurlow, J, McNulty, S, Brown-Elliott, BA, Wallace, RJ, Falkinham, JO. Nontuberculous Mycobacteria in household plumbing as possible cause of chronic rhinosinusitis. Emerg Infect Dis 2012;18:1612–17CrossRefGoogle ScholarPubMed
36Hammarström, L, Vorechovsky, I, Webster, D. Selective IgA deficiency (SIgAD) and common variable immunodeficiency (CVID). Clin Exp Immunol 2000;120:225–31CrossRefGoogle ScholarPubMed
37Rodríguez, A, Tjärnlund, A, Ivanji, J, Singh, M, Garcia, I, Williams, A et al. Role of IgA in the defense against respiratory infections IgA deficient mice exhibited increased susceptibility to intranasal infection with Mycobacterium bovis BCG. Vaccine 2005;23:2565–72CrossRefGoogle ScholarPubMed
38Newport, MJ, Huxley, CM, Huston, S, Hawrylowicz, CM, Oostra, BA, Williamson, R et al. A mutation in the interferon-gamma-receptor gene and susceptibility to mycobacterial infection. N Engl J Med 1996;335:1941–9CrossRefGoogle ScholarPubMed
39Rosai, J. Rosai and Ackerman's Surgical Pathology, 10th edn.St Louis: Mosby, 2011;38,99–100,352–3,2107Google Scholar
40Petrini, B. Mycobacterium abscessus: an emerging rapid-growing potential pathogen. APMIS 2006;114:319–28CrossRefGoogle ScholarPubMed
41Griffith, DE, Aksamit, T, Brown-Elliott, BA, Catanzaro, A, Daley, C, Gordin, F et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 2007;175:367–416CrossRefGoogle ScholarPubMed
42Madaras-Kelly, KJ, DeMasters, TA, Stevens, DL. Mycobacterium fortuitum meningitis associated with an epidural catheter: case report and a review of the literature. Pharmacotherapy 1999;19:661–6CrossRefGoogle Scholar
43Arkun, K, Gordon, DA, Lincoln, C, Levi, M, Bello, J, Keller, C et al. Atypical mycobacterial brain abscess presenting as a spindle cell lesion in an immunocompetent patient. Clin Neuropathol 2012;31:155–8CrossRefGoogle Scholar
44Florakis, D, Kontogeorgos, G, Anapliotou, M, Mazarakis, N, Richter, E, Brück, W et al. Isolated pituitary granuloma by atypical Mycobacterium in a nonimmunosuppressed woman. Clin Endocrinol (Oxf) 2002;56:123–6CrossRefGoogle Scholar