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Nontuberculous mycobacterial mastoiditis

M G Stewart1, J Troendle-Atkins, J R Starke

  • 1Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex.

Archives of Otolaryngology--Head & Neck Surgery
|February 1, 1995
PubMed
Summary

Nontuberculous mycobacterial (NTM) mastoiditis is a rare but serious infection in infants. Surgical mastoidectomy is the preferred treatment, unlike tuberculous mastoiditis which responds to chemotherapy.

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Area of Science:

  • Otolaryngology
  • Pediatric Infectious Diseases
  • Microbiology

Background:

  • Nontuberculous mycobacterial (NTM) infections commonly cause cervicofacial lymphadenopathy in children.
  • NTM mastoiditis is a rare clinical presentation, often challenging to differentiate from tuberculous mastoiditis due to similar symptoms like chronic otorrhea and middle ear granulation.

Observation:

  • A case of mastoiditis caused by Mycobacterium avium complex (MAC) in an infant presented with a temporal bone mass.
  • The infant's presentation highlighted the diagnostic difficulties in distinguishing NTM from tuberculous mastoiditis.

Findings:

  • Mycobacterium avium complex (MAC) mastoiditis requires a different treatment approach than tuberculous mastoiditis.
  • NTM infections, including MAC, exhibit resistance to standard antituberculosis chemotherapy.

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Implications:

  • Mastoidectomy is the recommended surgical treatment for NTM mastoiditis, contrasting with the medical management of tuberculous mastoiditis.
  • This case underscores the importance of considering NTM in the differential diagnosis of pediatric mastoiditis, especially when clinical presentation is atypical or resistant to initial treatments.