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Recurrent therapy resistant mastoiditis by Mycobacterium cheilonae abscessus, a nontuberculous mycobacterium
A van Aarem1, H L Muytjens, M M Smits
1Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands.
Summary
Recurrent mastoiditis caused by nontuberculous mycobacteria (NTM) can present with slow wound healing. Consider NTM infection in children with chronic middle ear infections unresponsive to standard treatment.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- Nontuberculous mycobacterial (NTM) infections are increasingly recognized.
- Middle ear infections are a common pediatric condition, typically treated with antibiotics and surgical intervention.
Observation:
- A rare case of recurrent mastoiditis with abscess formation caused by Mycobacterium chelonae abscessus is presented.
- The patient exhibited exceptionally slow wound healing following repeated surgical debridement.
- Literature review indicated that middle ear NTM infections predominantly affect immunocompetent children.
Findings:
- Mycobacterium chelonae abscessus was identified as the causative agent.
- Chronic unilateral otitis media unresponsive to conventional therapies may indicate a mycobacterial etiology.
- Histopathological and microbiological investigations are crucial for diagnosis.
Implications:
- This case highlights the importance of considering NTM infections in refractory middle ear disease.
- Early and accurate diagnosis through specialized investigations can lead to appropriate management.
- Understanding the unique presentation of NTM in the middle ear is vital for pediatric otolaryngology.