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Rare disease
CASE REPORT
Congenital tuberculosis presenting as otorrhoea in a preterm infant
  1. Jose Carlos Aldana-Aguirre1,2,
  2. Hamdy El-Hakim1,3,
  3. Ernest Phillipos1,2,
  4. Marc-Antoine Landry1,2
  1. 1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
  2. 2Neonatology, Stollery Children’s Hospital, Edmonton, Alberta, Canada
  3. 3Pediatric Otolaryngology, Stollery Children’s Hospital, Edmonton, Alberta, Canada
  1. Correspondence to Dr Marc-Antoine Landry, marc-antoine.landry{at}ualberta.ca

Summary

A premature infant of 25 weeks’ gestational age presented at 8 weeks after birth with otorrhoea from the left ear. Following a course of topical and systemic antibiotics, the patient deteriorated developing facial nerve paralysis and cervical lymphadenitis. Contrast-enhanced CT and MRI of the head showed a destructive process of the left temporal bone. These findings prompted the clinicians to send swabs from the purulent discharge from the ear for acid-fast bacilli stain. Furthermore, surgical exploration and debridement were undertaken. Cultures from ear discharge and biopsy—taken during surgical procedure—revealed the presence of Mycobacterium tuberculosis complex. The patient developed necrotizing otitis media, left temporal bone osteomyelitis and cervical lymphadenitis. The infant’s mother was found to have an endometrial biopsy positive for M. tuberculosis suggesting the diagnosis of congenital tuberculosis.

  • neonatal and paediatric intensive care
  • neonatal health

https://doi.org/10.1136/bcr-2017-221797

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    Footnotes

    • Contributors JCAA and MAL contributed to all stages of the case report. JCAA wrote the first draft of the manuscript. HEH provided the images. HEH and EP contributed to the review of the manuscript. MAL reviewed all drafts of the manuscript. All authors approved the final manuscript as submitted.

    • Competing interests None declared.

    • Patient consent Guardian consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.