gms | German Medical Science

The infestation of the ear and petrous bone in a tuberculosis infection is a rarity in the field of Otolaryngology.

We refer to the case of a 5-year-old boy born in Romania applying to pediatric orthopedics with a swelling of the forefoot. The x-ray of the forefoot showed the picture of a spina ventosa. Because of a painless unilateral otorrhea, the patient was presented in our ENT-clinic. Ear microscopy showed a tumorous threaded acoustic duct. The audiogram showed a moderate conductive hearing loss. Based on the synopsis of the findings and the suspicion of a tuberculosis infection a whole-body MRI was performed. It showed the picture of a miliary tuberculosis, which was confirmed biochemically. We conducted a quadruple antituberculous therapy and surgical reconstruction of the ear and the foot. In summary, this case shows that also in Germany there might exist far advanced findings of rarely occurring diseases even if you have disproportional low symptoms. Therefore, one should consider a tuberculosis infection in particular if non-specific symptoms such as prolonged otorrhea appear. Furthermore, the importance of diagnostic imaging becomes clear, especially the MRI examination was indicative finding the diagnosis. On confirmation of the suspicion a systemic tuberculostatic therapy should be initiated and the success should be checked. In most cases, drug therapy is sufficient to cure tuberculosis. However, an additional surgical repair of local manifestations may be necessary to a restitution ad integrum.