Sholikhin Trilistya,Merry Lia,MS Anam,Dwi Wastoro Dadiyanto,Magdalena Sidhartani
Department of Pediatrics Faculty of Medicine Diponegoro University Dr Kariadi Hospital
Background : Tuberculosis (TB) is a global health problem, which can affects various organs. Incidence of Mastoid TB is very rare, 0.05-0.9% of all tuberculosis cases, 0.04% of all chronic otitis and 4% of head neck tuberculosis. Despite the rarity, it can cause severe complications. A case of mastoiditis TB will be reported.
Case Presentation Summary : Nine years old boy admitted in Dr. Kariadi Hospital on April 2018 with 4 months fluid discharge from the left ear. Contact of TB was undetermined. Physical examination revealed no BCG scar, normal vital signs, no chest abnormalities, moderate malnutrition. Mucopurulent liquid was found in the left ear, granulomatous tissue at external auditory, and a tender post-operative wound in the left retroauricular. MSCT showed left otomastoiditis and cholesteatoma. Mastoid tissue staining showed positive Acid Fast Bacilli (AFB). Chest X-Ray was within normal limits. Audiometric found medium degree conductive hearing loss of left ear. Treatment is 2RHZE (4 paediatric FDC + Ethambutol 400 mg) / 10RH and prednisone 2mg/kg/day for 2 weeks then tappered off. The boy was discharged after 7 days. Treatment was continued and monitored at our hospital for 2 months and then at the nearest Primary Health Care. The ear discharge AFB staining and ENT evaluation will be done after 2 months. Nutritional intervention showed increase body weight from 20 kg (WHZ = -2.1 SD) to 21.5 kg (WHZ = -1.18 SD) after 1 month.
Learning Points/Discussion : Tuberculosis can spread to any organ. Thus, clinicians need more awareness in managing patients of the possibility of extrapulmonary spreading. Mastoiditis TB is a rare case and had hearing loss as complication. The success of treatment in this patient still need to be monitored.
Keywords: tuberculosis mastoiditis hearing loss
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