Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind
Mycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who...
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doaj-4c4766d2a3374643b57f7b6cbf1cdee82020-11-25T03:55:44ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942020-02-0110.12890/2020_0014691125Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in MindBárbara Pedro0Marta Meleiro1António Marinho2Clinical Immunology Unit, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal; Department of Internal Medicine, Hospital Professor Doutor Fernando Fonseca, Lisbon, PortugalClinical Immunology Unit, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, Portugal; Department of Internal Medicine, Unidade Hospitalar de Chaves, Centro Hospitalar de Trás-os-Montes e Alto Douro, Chaves, PortugalClinical Immunology Unit, Hospital de Santo António, Centro Hospitalar Universitário do Porto, Porto, PortugalMycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who was immediately started on immunosuppressive treatment. Years later, she developed progressive hypoacusis. Magnetic resonance imaging (MRI) revealed an extensive mass in the tympanic cavity extending to the mastoid. A biopsy of the mass was positive for Mycobacterium tuberculosis. Immunosuppressants were weaned and the patient was started on anti-tuberculous therapy with resolution of the complaints and findings. Tuberculous infections are difficult to diagnose and frequently mimic other illnesses, but in our case, we believe that an indolent tuberculous process was present from the beginning and evolved under immunosuppressive therapy.https://www.ejcrim.com/index.php/EJCRIM/article/view/1469tuberculosisimmunosuppressionmastoiditisbiopsy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bárbara Pedro Marta Meleiro António Marinho |
spellingShingle |
Bárbara Pedro Marta Meleiro António Marinho Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind European Journal of Case Reports in Internal Medicine tuberculosis immunosuppression mastoiditis biopsy |
author_facet |
Bárbara Pedro Marta Meleiro António Marinho |
author_sort |
Bárbara Pedro |
title |
Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind |
title_short |
Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind |
title_full |
Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind |
title_fullStr |
Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind |
title_full_unstemmed |
Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind |
title_sort |
not all ent granulomas are wegener’s – keep tuberculosis in mind |
publisher |
SMC MEDIA SRL |
series |
European Journal of Case Reports in Internal Medicine |
issn |
2284-2594 |
publishDate |
2020-02-01 |
description |
Mycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who was immediately started on immunosuppressive treatment. Years later, she developed progressive hypoacusis. Magnetic resonance imaging (MRI) revealed an extensive mass in the tympanic cavity extending to the mastoid. A biopsy of the mass was positive for Mycobacterium tuberculosis. Immunosuppressants were weaned and the patient was started on anti-tuberculous therapy with resolution of the complaints and findings. Tuberculous infections are difficult to diagnose and frequently mimic other illnesses, but in our case, we believe that an indolent tuberculous process was present from the beginning and evolved under immunosuppressive therapy. |
topic |
tuberculosis immunosuppression mastoiditis biopsy |
url |
https://www.ejcrim.com/index.php/EJCRIM/article/view/1469 |
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