A case of tuberculous otitis media complicated by facial paralysis

Abstract

The incidence of tuberculosis (TB) in Japan has been decreasing each year, and in 2021, Japan became a low-endemic country for TB. Many cases take time to be diagnosed because of the rarity of encountering TB in daily medical practice and the variety of clinical presentations. The prevalence of TB remains high in neighboring Asian countries, and the number of foreign-born patients in Japan is on the rise. We experienced a case of tuberculous otitis media complicated by facial nerve palsy about one and a half months after the onset of subjective symptoms and severe mixed hearing loss about one week after the onset of symptoms. The tympanic membrane at the time of the initial examination showed acute otitis media-like findings, and the progression of symptoms was observed in a short period of time compared to the general course of tuberculous otitis media reported thus far. The possibility of tuberculous otitis media considered when a patient presents with an unusual course, as Mycobacterium tuberculosis is not detected in a general bacteriological examination, and its course needs to be differentiated from ANCA-associated otitis media with vasculitis and other diseases.