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Tuberculous mastoiditis in a 2-month-old infant presenting with facial nerve palsy

David McMaster1, Waqas Bm Din2, Babu Ramalingaiah3

  • 1University of Nottingham School of Medicine, Nottingham, UK mzydhm@nottingham.ac.uk.

BMJ Case Reports
|December 10, 2020
PubMed

Insights

A rare case of tuberculous mastoiditis in an infant was diagnosed using rapid molecular testing. Prompt treatment of this Mycobacterium tuberculosis infection led to the infant's recovery and resolution of facial nerve palsy.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Tuberculous mastoiditis is an uncommon complication of Mycobacterium tuberculosis infection, particularly in infants.
  • Early diagnosis and treatment are crucial for favorable outcomes.

Observation:

  • A 2-month-old infant presented with facial nerve palsy, fever, and otorrhoea.
  • Computed tomography (CT) scan confirmed mastoiditis.

Findings:

  • Gastric aspirate analysis using the Xpert MTB/RIF assay rapidly identified Mycobacterium tuberculosis.
  • The diagnosis of tuberculosis (TB) allowed for prompt initiation of anti-TB therapy.

Implications:

  • This case highlights the utility of molecular diagnostics like Xpert MTB/RIF in identifying TB in infants with mastoiditis.
  • Early diagnosis and treatment can lead to complete recovery, including resolution of neurological deficits such as facial nerve palsy.

Keywords:
Infectious diseasesTB and other respiratory infectionsearnose and throat/otolaryngologypaediatrics

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