A typical mycobacterial otomastoiditis

Abstract

Abstract A typical mycobacterial infections of the middle ear and mastoid are rare; only 4 isolated cases and an outbreak of 17 cases have been reported. Herein are presented three additional cases with chronic otorrhea unresponsive to routine medical therapy. Two were due to Mycobacterium avium‐intracellulare and the third to Mycobacterium chelonei . All three patients had negative tuberculin test results and normal chest radiographs. Pathologic study reveals granulomatous inflammation, usually with negative acid‐fast stains. Tissue culture should be incubated for a minimum of 4 weeks. These patients often undergo multiple otologic procedures and have abundant granulation tissue with normal ossicles. The antibiotic therapy is prolonged, and the organisms may be resistant to the usual antituberculous drugs. Unlike many atypical mycobacterial infections today, those involving the middle ear can occur in immunologically normal individuals.