Subject(s)
Humans , Child , Otitis Media/drug therapy , Anti-Bacterial Agents/administration & dosage , Otitis Media/classification , Otitis Media/diagnosis , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/drug therapy , Otitis Media with Effusion/diagnosis , Otitis Media with Effusion/drug therapy , Acute Disease , Practice Guidelines as TopicSubject(s)
Humans , Female , Infant , Histiocytosis/diagnosis , Mastoiditis/diagnosis , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/microbiology , Tuberculosis/diagnosis , Tuberculosis/diagnostic imaging , Antitubercular Agents/therapeutic use , Diagnosis, Differential , Immunologic Deficiency Syndromes/diagnosis , Mycobacterium tuberculosis/isolation & purification , Tuberculosis/drug therapySubject(s)
Humans , Male , Adolescent , Brain Abscess/diagnosis , Cholesteatoma, Middle Ear/diagnosis , Labyrinthitis/diagnosis , Lemierre Syndrome/diagnosis , Mastoiditis/diagnosis , Otitis Media, Suppurative/complications , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/drug therapy , Anti-Bacterial Agents/therapeutic use , Diagnosis, DifferentialABSTRACT
Las enfermedades del oído medio representan la causa más frecuente de otorrea en la infancia. En nuestro medio, la persistencia de la misma determina la consulta especializada al otorrinolaringólogo. Objetivo: Determinar las características clínicas y las causas de otorrea en la infancia en nuestro medio. Pacientes y métodos: Estudio prospectivo, longitudinal y descriptivo durante 5 meses en un servicio de ORL de un hospital pediátrico durante los meses de septiembre 2015 a Febrero 2016. Se evaluaron 74 niños derivados por primera vez al otorrinolaringólogo por presentar otorrea. Se realizó otoaspiración, otomicroscopía y demás prácticas diagnósticas y terapéuticas. Resultados: Se incluyeron 72 niños en el estudio. El 41.7% niñas y el 58,3% varones. La edad media fue 36 meses (rango 3-179 meses). El motivo de consulta predominante fue la otorrea purulenta. El tiempo medio de otorrea fue 13 días (rango 1-180 días). El 61,1% de los pacientes estaba recibiendo tratamiento antimicrobiano empírico. El 78% de los casos presentaron catarro de vías aéreas superiores (CVAS) previo al episodio de otorrea. Se diagnosticó otitis media crónica simple (OMCS) en el 48,6%, otitis media aguda supurada (OMAS) en el 33,3%, otitis externa (OE) en el 9,7%; otitis media crónica colesteatomatosa (OMCC) en el 2,8%; miringitis bullosa (MB) en 2.8% y, en 2 casos (2,8%), histiocitosis de células de Langerhans. Conclusiones: La otomicroscopía y la otoaspiración son elementos fundamentales para el diagnóstico causal de la otorrea en la infancia. Considerar la edad mediana, los signos y síntomas asociados es importante para el diagnóstico presuntivo diferencial. La otitis media aguda supurada y la otitis media crónica simple reagudizada son las causas más comunes de otorrea en la infancia (AU)
Diseases of the middle ear are the most frequent cause of otorrhea in children. In our setting, persistent otorrhea requires consultation with the otolaryngologist. Objective: To determine the clinical features and causes of otorrhea in childhood in our setting. Patients and methods: A 5-month prospective, longitudinal, descriptive study was conducted at the Department of ENT of a pediatric hospital between September 2015 and February 2016. Seventy-four children were evaluated for the first time by an otolaryngologist because of otorrhea. Aspiration, otomicroscopy, and other diagnostic and therapeutic procedures were performed.Results: 72 children were included in the study; 41.7% were girls and 58.3% boys. Mean age was 36 months (range, 3-179 months). The main reason for consultation was purulent otorrhea. Mean duration of otorrhea was 13 days (range, 1-180 days). Of all patients, 61.1% was receiving empiric antimicrobial treatment. Overall, 78% of the cases had had an upper resprtaory tract infection (URTI) prior to the episode of otorrhea. Simple chronic otitis media (SCOM) was diagnosed in 48.6%, acute otitis media (AMO) in 33.3%, external otitis (EO) in 9.7%, chronic cholesteatomatous otitis media (CCOM) in 2.8%, myringitis bullosa (MB) in 2.8%, and Langerhans cell histiocytosis in 2 cases (2.8%). Conclusions: Otomicroscopy and aspiration are fundamental tools in the diagnosis of otorrhea in children. Median age and the associated signs and symptoms are important in the differential diagnosis. Acute suppurative otitis media and acute episodes of simple chronic otitis media are the most common causes of otorrhea in childhood (AU)
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/drug therapy , Otitis Media, Suppurative/etiology , Cholesteatoma, Middle Ear , Longitudinal Studies , Prospective StudiesABSTRACT
Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of ear infections. We attempted to evaluate the clinical usefulness of arbekacin in treating chronic suppurative otitis media (CSOM) by comparing its clinical efficacy and toxicity with those of vancomycin. Efficacy was classified according to bacterial elimination or bacteriologic failure and improved or failed clinical efficacy response. Ninety-five subjects were diagnosed with CSOM caused by MRSA. Twenty of these subjects were treated with arbekacin, and 36 with vancomycin. The bacteriological efficacy (bacterial elimination, arbekacin vs. vancomycin: 85.0% vs. 97.2%) and improved clinical efficacy (arbekacin vs. vancomycin; 90.0% vs. 97.2%) were not different between the two groups. However, the rate of complications was higher in the vancomycin group (33.3%) than in the arbekacin group (5.0%) (P=0.020). In addition, a total of 12 adverse reactions were observed in the vancomycin group; two for hepatotoxicity, one for nephrotoxicity, eight for leukopenia, two for skin rash, and one for drug fever. It is suggested that arbekacin be a good alternative drug to vancomycin in treatment of CSOM caused by MRSA.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Anti-Bacterial Agents/administration & dosage , Chronic Disease , Dibekacin/administration & dosage , Methicillin-Resistant Staphylococcus aureus/drug effects , Otitis Media, Suppurative/diagnosis , Staphylococcal Infections/diagnosis , Treatment Outcome , Vancomycin/administration & dosageABSTRACT
Chronic suppurative otitis media is one of the common ear diseases of the ear, particularly in childhood. It is the commonest cause of persistent mild to moderate hearing impairment in children and young adults. AIM: To find out the prevalence of chronic suppurative otitis media among school children studying in urban private schools of Nepal. MATERIAL AND METHODS: This study was carried out among 500 school children aged between 5 -15 years. Students were selected from urban private schools of four districts of Nepal. In all students, history was taken and otoscopic examination done from May 2006 to October 2006. Data were described using frequency and percentage. Study design: Prospective cross sectional study. RESULTS: Results showed that the prevalence of chronic suppurative otitis media in children studying in urban private schools of Nepal is 5.0 percent. Unilateral disease was seen in 72.0 percent, 76.0 percent had a tubotympanic disease and 24.0 percent had atticoantral disease. CONCLUSION: The prevalence of chronic suppurative otitis media in urban private school children in Nepal is higher than other studies done in private school children. Health education, improvement of socioeconomic status and health facilities will be helpful in reducing the prevalence of chronic suppurative otitis media.
Otite média crônica supurativa é uma das mais comuns doenças do ouvido, principalmente em crianças. É a causa mais comum de perda auditiva persistente leve a moderada em crianças e adultos. OBJETIVO: encontrar a prevalência de otite média crônica supurativa em crianças de escolas particulares urbanas do Nepal. MATERIAIS E MÉTODOS: este estudo envolveu 500 crianças escolares com idades entre 5 e 15 anos. Os estudantes foram selecionados de escolas particulares urbanas de quatro distritos do Nepal. Todas as crianças passaram por anamnese e exame otoscópico entre Maio e Outubro de 2006. Os dados foram descritos por meio de freqüência e porcentagem. Formato do estudo: transversal e prospectivo. RESULTADOS: os resultados mostraram que a otite média crônica supurativa em crianças de escolas particulares do Nepal é de 5,0 por cento. Doença unilateral esteve presente em 72,0 por cento; 76,0 por cento tiveram doença tubo-timpânica e 24,0 por cento tiveram doença ático-coanal. CONCLUSÃO: a prevalência de otite média crônica supurativa em crianças de escolas particulares urbanas do Nepal é maior do que aquele encontrado em outros estudos envolvendo crianças de escolas particulares. Educação em saúde, estado sócio-econômico e instalações de atenção à saúde serão úteis na redução da prevalência de otite média crônica supurativa.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Otitis Media, Suppurative/epidemiology , Chronic Disease , Cross-Sectional Studies , Nepal/epidemiology , Otitis Media, Suppurative/diagnosis , Prevalence , Prospective Studies , Urban PopulationABSTRACT
In chronic suppurative otitis media aerobic Gram positive, Gram negative and anaerobes are found. Middle ear specimen for bacterial culture can be obtained by using sterile swabs and nichrome wire loop separately. To study difference in isolation of bacterial pathogens in cases of CSOM using sterile swabs and nichrome wire loop to obtain middle ear specimen and find a simple, safe, and effective method of collecting middle ear specimen. Study of 100 tubotympanic cases from CSOM patients and collection of ear discharge samples with conventional sterile swabs and Nichorme wire loop separately. Selection of 100 tubotympanic cases from CSOM patients on the basis of history, clinical features, microscopic examination of tympanic membrane by E.N.T. consultant and processing of ear swabs for bacterial culture isolation. The ear discharge sampled with nichrome wire loop [n=100] and conventional sterile swab [n=100] yielded 208 and 221 isolates respectively. Staphylococcus aureus represented 36.5% and 34.3% Pseudomonas aeruginosa 25.9% and 24.4% proteus species 12.5% and 11.7% of the total isolates obtained. Bacterial isolates from ear samples taken with conventional sterile swab were found to be identical to those with nichrome wire loop. Conventional sterile swab is a simple, safe, cheap and effective method of collecting middle ear specimen
Subject(s)
Humans , Otitis Media, Suppurative/diagnosis , Bacteriological Techniques/methods , Staphylococcus aureus/isolation & purification , Pseudomonas aeruginosa/isolation & purification , Culture Media , Proteus/isolation & purificationABSTRACT
Conocida como es la rebeldía de las otitis medias supuradas a todo tratamiento y lo peligrosas que son ya como causa de sordera incurable por ankilosis de los huesecillos ya por determinan más o menos tarde, abscesos cerebrales o complicaciones meníngeas, he creído oportuno hacer conocer la observación siguiente que demuestra la necesidad del examen auricular sistemático en los niños ata-cados de infecciones nasolaríngicas y bronquias, así como la eficacia del tratamiento de Pech por éter sulfúrico. El niño J.A.R., de dos años de edad, fue atacado de bronquitis aguda generalizada a los gruesos y medianos bronquios de ambos pulmones con temperatura de 39° y 39,5. Lo traté con revulsión, benzoato de soda, expectorantes y baños calientes. Después de quince días de tratamiento la temperatura bajó a 36°y décimos, los signos estetoscópicos desaparecieron, el apetito volvió y todo correspondió a una convalecencia franca.
Subject(s)
Humans , Male , Child, Preschool , Otitis Media/diagnosis , Otitis Media/therapy , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/therapyABSTRACT
La otitis media agua con efusión purulenta retenida en el oído medio (OMAT) causa signos y sintomas (sindrome febril, otodinia, membrana timpànica abombada, engrosada y congestiva), que usualmente no ceden con tratamiento antibiótico. Con el aumento creciente de resistencia bacteriana, la timpanocentesis debe ser considerada en el diagnóstico y tratamiento de la OMAP. Objetivo: determinar si hay diferencias entre las características clínicas y bacteriología del exudado purulento retenido en oído medio en pacientes con tratamiento antibiótico por ese episodio de otitis media aguda y en aquellos sin tratamiento previo. Se realizó un estudio prospectivo mediante timpanocentesis y toma de muestra para cultivo, a niños con diagnóstico de OMAP Los niños fueron incluidos en dos grupos: 94 con OMAP sin tratamiento antibiótico (ATB) previo y 95 con OMAP que no respondieron a uno o dos cursos de ATB indicado empiricamente. El estudio se realizó en el Servicio de Otorrinolaringología del Hospital Garrahan desde enero a julio 1999. Pacientes y Métodos: Niños con diagnóstico presuntivo de OMAP fueron evaluados mediante otomicroscopía. Cuando se diagnosticó retención de efusión purulenta en oído medio, se realizó timpanocentesis y cultivo según técnicas convencionales. Resultados: se incluyeron 189 niños que cursaban OMAP. Se realizó timpanocentesis a 288 oídos. Los niños fueron incluídos en dos grupos: 94 OMAP sin ttratamiento antibiótico (ATB) previo y 95 con OMAP que no responfieron a uno o a dos cursos de ATB indicado empíricamente. En el grupo de niños con OMAP persistente, el tiempo medio de tratamiento antibiótico previo fue de 13 días (rango 4-90 días) 43/95 (45.3 por ciento) habían recibido tratamiento ATB adecuado a la sensibilidad de los gérmenes aislados en los cultivos respectivos. La ausencia de fiebre en el grupo tratado con ATB no implicó resolución de la OMAP al compararlo con el grupo no tratado (p=0.0069).
Subject(s)
Child , Anti-Bacterial Agents , Bacteriological Techniques , Comparative Study , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/therapyABSTRACT
La otitis media crónica supurada es una enfermedad del oído medio caracterizada por inflamación crónica de la mucosa del oído medio y mastoides, perforación de la membrana timpánica y otorrea. Para determinar las características clínicas de la OMC en niños se realizó un estudio prospectivo, longitudinal y descriptivo durante 3 meses en el Servicio de Otorrinolaringología del Hospital Nacional de Pediatría Prof. Dr. J. P. Garrahan. Población, material y métodos. De los pacientes asistidos en el Servicio de ORL se seleccionaron los que cumplían con los criterios diagnósticos de otitis media crónica: otorrea (permanente o intermitente) de más de tres meses de evolución, a través de perforación timpánica documentada por otomicroscopia. Se excluyeron aquellos con sospecha de colesteatoma, enfermedades tumorales, inmunodeficiencias primarias y secundarias, anomalías craneofaciales, síndromes genéticos y los que no concurrieron a controles posteriores. A todos se les realizó otomicroscopia, toma de material para cultivo y tratamiento local inicial con alcohol 70 boricado a saturación. Resultados. De 115 niños con otitis media crónica se incluyeron 96 en el estudio (51 por ciento [n igual 49] masc menos 49 por ciento [n igual 47] fem). Edad media: 77 más o menos 43,78 meses. El tiempo medio de otorrea fue de 12 meses (rango 1 menos 175 m). Presentaban sinusopatía maxilar 48 (50 por ciento) pacientes. La otitis crónica era bilateral en 33,3 por ciento (32) y unilateral en 66,7 por ciento (64). Microbiología: se aislaron 153 gérmenes del material aspirado de oído medio, 50 por ciento (48) de los cultivos fueron polimicrobianos. Las bacterias más comunes fueron Pseudomonas aeruginosa (53/153) y Proteus (33/153). Desarrollaron gérmenes anaerobios 18/153 cultivos. El tratamiento inicial con alcohol 70 boricado a saturación resolvió la otorrea en el 77 por ciento de los casos
Subject(s)
Child , Otitis Media, Suppurative/complications , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/microbiology , Otitis Media, Suppurative/therapy , Tympanic Membrane Perforation , Epidemiology, Descriptive , Longitudinal Studies , Prospective StudiesABSTRACT
Audiometric screening was conducted in Dhofar region to study the magnitude of ear problems and cost-effectiveness of screening first-year preparatory-school children in Oman. None of the 1894 pupils had otitis media with effusion or sensory neuronal hearing loss. Six children [0.32%] had impacted wax, 4 [0.21%] chronic suppurative otitis media and 2 [0.11%] dry perforation of eardrum. In all, 14 children [0.74%] with suspected hearing impairment were referred to a specialist but only 2 attended. Physicians and nurses spent 8-10 minutes for ear examination per child for a yield of less than 1%. The screening expenditure was US$ 5 per pupil. As the prevalence of serious ear conditions was low, we conclude that exp and ing the audiometric screening of schoolchildren to first-year preparatory pupils is not cost-effective
Subject(s)
Child , Female , Humans , Male , Cerumen , Chronic Disease , Cross-Sectional Studies , Forecasting , Health Expenditures/statistics & numerical data , Mass Screening/economics , Otitis Media, Suppurative/diagnosis , School Health Services/economicsABSTRACT
There is a high rate of use of antimicrobial drugs for otitis media in children. This article reviews the diagnostic considerations for acute otitis media. An extensive review of literature on this subject has been carried out in order to address the issues of indications, choice, appropriate doses of antimicrobial agents and the duration for which they should be used. It is important to distinguish acute otitis media from otitis media with effusion because antibiotics are seldom indicated for the latter condition. Oral amoxicillin remains first-line therapy for uncomplicated acute otitis media, a short course of antimicrobial therapy (five to seven days) may be appropriate in children two years of age or older with uncomplicated presentations. For clinical treatment failures after 3 days of amoxicillin, recommended antimicrobial agents include oral amoxicillin/clavulanate, cefuroxime axetil, cefprozil, cefpodoxime proxetil, and intramuscular (i.m.) ceftriaxone. Tympanocentesis for identification of pathogens and susceptibility to antimicrobial agents is recommended for selection of third-line agents.
Subject(s)
Algorithms , Anti-Bacterial Agents/therapeutic use , Child , Diagnosis, Differential , Drug Resistance, Microbial , Humans , Otitis Media/diagnosis , Otitis Media with Effusion/diagnosis , Otitis Media, Suppurative/diagnosis , Practice Guidelines as Topic , Risk FactorsABSTRACT
A case of Otitis media, a rare complication of Salmonella senftenberg infection is reported.
Subject(s)
Humans , Infant, Newborn , Otitis Media, Suppurative/diagnosis , Salmonella Infections/diagnosisABSTRACT
The efficacy and safety of 0.3 per cent Ofloxacin otic solution (OFLX) 6 drops twice daily was compared with those of oral Amoxycillin 500 mg three times daily plus 1 per cent Chloramphenicol ear drop at 3 drops three times daily (AMOX + CRP) in a two-week treatment of chronic suppurative otitis media (CSOM) with acute exacerbation. 80 adult patients were enrolled in a prospective, randomized, investigator-blind study at the outpatient ENT service of Chulalongkorn University Hospital. The most common pathogens isolated at the pretreatment visit were Staphylococcus aureus (30.3%) and Pseudomonas aeruginosa (24.7%). The susceptibility of all the pathogenic isolates to ofloxacin, amoxycillin and chloramphenicol were 96.4, 57.1 and 51.8 per cent respectively. The overall response expressed as an improvement or cure of otalgia, otorrhea and middle ear mucosal inflammation was recorded. It revealed that the improvement rate of the OFLX-treated patients was better than that of AMOX + CRP-treated, but was not statistically significant. However, the cure rate was significantly better in OFLX-treated than in AMOX + CRP-treated groups in terms of painless (p = 0.05) and dry (p < 0.001) ears. Ototoxicity was assessed by an elevation in bone conduction threshold (BC) and/or speech reception threshold (SRT) of greater than 5 dB or a presence of high tone hearing loss resulting from treatments. A significant decrease in BC and SRT was revealed in OFLX-treated ears (p < 0.0001; p = 0.002 respectively) but a significant elevation of BC was found in AMOX + CRP-treated ears (p = 0.007). The ototoxic rate was significantly higher in AMOX + CRP-treated than in OFLX-treated ears whether assessed by BC (p < 0.001) or SRT (p = 0.03). In conclusion, OFLX was more effective and safer than AMOX + CRP in the treatment of CSOM with acute exacerbation.
Subject(s)
Administration, Oral , Administration, Topical , Adolescent , Adult , Aged , Amoxicillin/administration & dosage , Anti-Infective Agents/administration & dosage , Chi-Square Distribution , Chloramphenicol/administration & dosage , Chronic Disease , Double-Blind Method , Drug Therapy, Combination/administration & dosage , Female , Follow-Up Studies , Humans , Male , Middle Aged , Ofloxacin/administration & dosage , Otitis Media, Suppurative/diagnosis , Penicillins/administration & dosage , Prospective Studies , Recurrence , Treatment OutcomeABSTRACT
The inflammatory diseases of external and middle ear are one of the commonest conditions encountered by the pediatric physician. Inner ear inflammations are less common and need special and urgent attention. Special management in each case requires detailed history, examination, necessary investigations and appropriate referral to otolaryngologist when necessary. The article is aimed to help formulate a plan in managing the inflammatory conditions of ear. Otalgia constitutes the most prominent of the symptoms in external and middle ear inflammations whereas vertigo, tinnitus and sensory hearing loss form the symptom complex for inner ear infections. It is necessary to understand the basic pathophysiology of the inflammatory condition to be able to institute a targetted treatment. The audiometry impedance studies, microbiology of discharge and occasionally ABR and CT scan from the mainstay of investigative workup. The treatment is specific and based on the precise diagnosis. It often requires the help of an otolaryngologist. Decisions may have to be made with regards to the need for any surgical intervention particularly in acute otitis media, an external canal abscess or an acute mastoiditis. A case of chronic otitis media with facial palsy or vertigo (labyrinthitis being a possibility) needs urgent intervention.
Subject(s)
Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Male , Mastoiditis/diagnosis , Otitis Media with Effusion/diagnosis , Otitis Media, Suppurative/diagnosis , PrognosisABSTRACT
A otite média crônica supurada (OMCS) é uma doença bastante freqüente no nosso meio, necessitando muitas vezes intervençäo cirúrgica. Complicaçöes também podem ocorrer, às vezes fatais. Os autores apresentam Revisäo da Literatura dos últimos cinco anos da otite média crônica supurada, com enfoque para a doença na infância. Definem a otite média crônica supurada como otorréia persistente há mais de três meses, apresentando a incidência. Relatam os fatores de risco, a fisiopatologia para cronificaçäo do processo inflamatório, os agentes mais freqüentes, o diagnóstico clínico e a importância do estudo audiológico e de imagem, o tratamento clínico e cirúrgico, e as complicaçöes que podem decorrer da otite média crônica supurada, principalmente da colesteatomatosa.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Otitis Media, Suppurative/epidemiology , Brazil , Chronic Disease , Incidence , Otitis Media, Suppurative/surgery , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/physiopathology , Risk FactorsABSTRACT
Os autores fazem uma revisao acerca das complicaçoes intracranianas das otites médias crônicas supurativas, chamando a atençao para a ainda alta incidência das mesmas e de sua potencialmente elevada morbi-mortalidade, ilustrando com apresentaçao de casos.
Subject(s)
Humans , Male , Female , Child , Adult , Brain Abscess/etiology , Meningitis/etiology , Otitis Media, Suppurative/complications , Sinus Thrombosis, Intracranial/etiology , Brain Abscess/diagnosis , Brain Abscess/physiopathology , Brain Abscess/therapy , Chronic Disease , Jugular Veins , Meningitis/diagnosis , Meningitis/physiopathology , Meningitis/therapy , Otitis Media, Suppurative/diagnosis , Otitis Media, Suppurative/therapy , Sinus Thrombosis, Intracranial/diagnosis , Sinus Thrombosis, Intracranial/physiopathology , Sinus Thrombosis, Intracranial/therapyABSTRACT
La TBC del oído medio constituye una entidad poco usual dentro de la patología pediátrica. Se analiza un caso de una lactante con otorrea de larga data, con ausencia de dolor; aunque difícil la evaluación auditiva por la edad, sin compromiso vestibular. Se evidenciaron ganglios regionales, particularmente periauriculares y cervicales. Se descartaron otros focos primarios en nariz, faringe o laringe. Un comienzo con gran componente inflamatorios, pero sin los pródromos usuales que preceden a los estados inflamatorios del oído medio . PPD (+) 15 mm. Cultivos de secreción ótica negativos para M. tuberculosis. Una biopsia ganglionar con linfadenitis crónica granulomatosa y necrosis gaseosa tipo tuberculoide. Entre los hallazgos concomitantes: déficit pondo-estatural con peso (-3 DE), talla (P3); relación peso/talla (-3 DE). Durante su permanencia se incluyó esquema anti TBC: isoniazida + rifampicina. Evolución intrahospitalaria satisfactoria. Se analizan aspectos relacionados con la TBC aural contenidos en la literatura