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Relationship between tuberculous otomastoiditis and tuberculous meningitis

Published online by Cambridge University Press:  17 August 2007

G Sonmez ,
V Turhan ,
M G Senol ,
E Ozturk ,
H O Sildiroglu  and
H Mutlu
G Sonmez*
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
V Turhan
Affiliation:
Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
M G Senol
Affiliation:
Department of Neurology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
E Ozturk
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
H O Sildiroglu
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
H Mutlu
Affiliation:
Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey
*
Address for correspondence: Dr Guner Sonmez, GATA Haydarpasa Egitim Hastanesi, 34668 Uskudar, Istanbul, Turkey. Fax: +90 216 5422808 E-mail: gunersonmez@hotmail.com
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Abstract

Objective:

The aim of this study was to determine the correlation between tuberculous meningitis and tuberculous otomastoiditis.

Materials and methods:

Meningeal involvement sites were investigated by magnetic resonance imaging in 32 patients (21 males, 11 females) who had previously been diagnosed with tuberculous meningitis. Clinical and laboratory findings and responses to anti-tuberculous treatment were evaluated, and the presence of concomitant tuberculous otomastoiditis was also investigated.

Results:

The meningeal involvement site was unilateral (in the sylvian fissure and the perimesencephalic cistern) in 28 patients (87.5 per cent), and bilateral and widespread in four patients (12.5 per cent). Tuberculous otomastoiditis was found in 11 of the patients with tuberculous meningitis (34.3 per cent). Otomastoiditis was on the same side as the meningeal involvement in nine of these 11 patients. Bilateral otomastoiditis with meningeal involvement was observed in two patients.

Conclusions:

Tuberculous meningitis is frequently accompanied by otomastoiditis, although the exact causal relationship between the two conditions is unclear. Since meningitis is a serious clinical condition, concomitant otomastoiditis generally remains unrecognised. Tuberculosis should be considered in the differential diagnosis of patients with otitis or otomastoiditis who do not respond to antibiotic therapy.

Keywords

TuberculosisMastoiditisMeningitisOtitis Media
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 9 , September 2008 , pp. 893 - 897
Copyright
Copyright © JLO (1984) Limited 2007

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