Paradoxical Reaction during Treatment of Pediatric Tuberculous Otitis Media

Abstract

According to data of the Health, Labor and Welfare Ministry, ear tuberculosis constituted 0.09% (21 cases) of all newly diagnosed tuberculosis patients in Japan in 2011. Only 3 cases of pediatric (0 to 14 years old) ear tuberculosis have been registered over the last decade. We present a case of a 7-year-old boy presented with unilateral aural discharge who was initially diagnosed with acute otitis media. He developed a paradoxical reaction of cervical lymph node swelling after 6 months of anti-tuberculosis treatment.

We should take into account the possibility of tuberculosis as a differential diagnosis of intractable otitis media. It is also important for clinicians to recognize paradoxical reactions during anti-tuberculosis treatment.