소아에서 결핵성 중이염 1례

A Case of Tuberculous Otitis Media in Children

결핵성 중이염은 매우 드문 질환이나 최근 결핵의 유병률이 증가하는 추세이므로 장기간의 항생제 치료에도 반응하지 않는 만성 중이염의 경우 결핵성 중이염의 가능성을 염두에 두어 감별진단 하여야 한다. 이런 관심은 조기 진단과 이에 따른 적절한 치료를 하게 되어 고막 파열, 청력 소실 및 안면신경마비와 같은 중한 합병증을 줄일 수 있을 것이다.

Tuberculous otitis media is a very rare disease in extrapulmonary tuberculosis and in chronic otitis media nowadays. The characteristic signs seem to have altered from the past ones. And the suspicion index is very low that there is often a considerable delay prior to diagnosis. This might result in irreversible complications such as hearing loss, facial nerve paralysis and labyrinthitis. It is difficult to be defined by culture, so many patients with tuberculous otitis media are subjected to have surgery without a correct etiologic diagnosis. Therefore bacteriologic study of secretion and pathologic examinations of biopsied tissue are mandatory. We report one year and 11 months old boy with tuberculous otitis media having painful otorrhea and perforated tympanic membrane diagnosed by histologic finding and polymerase chain reaction(PCR). And we would like to emphasize the fact that tuberculous otitis media must be considered in the differential diagnosis of persistent suppurative otitis media despite appropriate antibiotic therapy considering the increasing tendency in incidence of Tuberculosis in Korea these days.