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Isolated congenital tuberculosis otitis in a preterm infant
1Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
Insights
Congenital tuberculosis otitis in preterm infants can present unusually. This localized form shows regional lymphadenopathy, delayed symptoms, and antibiotic-resistant otitis, differing from disseminated cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Otolaryngology
Background:
- Congenital tuberculosis is rare and often disseminated.
- Neonatal otitis typically presents with different clinical features.
Observation:
- A preterm infant exhibited localized congenital tuberculosis otitis.
- Key signs included regional lymphadenopathy without systemic tuberculosis symptoms.
- The otitis presented with delayed onset and was refractory to standard antimicrobial treatments.
Findings:
- Localized congenital tuberculosis otitis is a distinct clinical entity.
- It is characterized by regional lymphadenopathy, delayed presentation, and treatment resistance.
- This presentation differs significantly from disseminated congenital tuberculosis.
Implications:
- Increased vigilance for neonatal tuberculosis is crucial in endemic areas.
- Early recognition of this localized form can improve diagnostic and treatment pathways.
- Consideration of tuberculosis in infants with refractory otitis is warranted, especially in high-risk populations.
Abstract:
We report an unusual case of localized congenital tuberculosis otitis in a preterm infant. Unlike disseminated congenital cases, the manifestations of localized otitis are associated with a triad of signs: (i) regional lymphadenopathy in the absence of typical systemic features of tuberculosis; (ii) delayed onset of presentation; and (iii) refractory otitis unresponsive to conventional antimicrobial agents. The need for greater diligence in looking for neonatal tuberculosis is emphasized, especially in an ethnic or socioeconomic environment where the disease is prevalent.