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<p>Tuberculous otitis media (TOM) and tuberculous cervical lymphadenitis (TCL) withabscess formation are uncommon extrapulmonary manifestations of tuberculosis (TB),particularly in children. This case report describes a rare instance of a 2-month-old male infant presenting with both conditions simultaneously, a highly unusual clinical scenario. The unvaccinated preterm infant exhibited chronic right ear discharge, a growing neck swelling, and intermittent fever for one month. Examination revealed a tender, fluctuant neck mass and purulent ear discharge. Initial antibiotic treatment failed, prompting further investigation. A CT scan showed middle ear and mastoid involvement with bone erosion and necrotic cervical lymph nodes. Surgical drainage and ear exploration confirmed thick pus and granulations, with tissue analysis revealing acid-fast bacilli, Mycobacterium tuberculosis via GeneXpert, and granulomatous inflammation with caseous necrosis, confirming TB. The absence of BCG vaccination likely increased the infant’s susceptibility to this severe dual presentation. This case highlights the iagnostic challenges of extrapulmonary TB in children, often mistaken for bacterial infections, and underscores the critical role of BCG vaccination in preventing severe TB forms. It emphasizes the need for suspicion of TB in persistent head and neck infections, to ensure timely diagnosis and treatment.</p>

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The Dual Manifestation of MTB: A Rare Case Report of Tuberculous Otitis Media and Neck Abscess in a Paediatric Patient

  • 期刊论文

  • 发表日期：

    2026年6月24日

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  • Shivani Dixit,
  • Prasun Mishra,
  • Anuja Ghoshal

摘要

Tuberculous otitis media (TOM) and tuberculous cervical lymphadenitis (TCL) withabscess formation are uncommon extrapulmonary manifestations of tuberculosis (TB),particularly in children. This case report describes a rare instance of a 2-month-old male infant presenting with both conditions simultaneously, a highly unusual clinical scenario. The unvaccinated preterm infant exhibited chronic right ear discharge, a growing neck swelling, and intermittent fever for one month. Examination revealed a tender, fluctuant neck mass and purulent ear discharge. Initial antibiotic treatment failed, prompting further investigation. A CT scan showed middle ear and mastoid involvement with bone erosion and necrotic cervical lymph nodes. Surgical drainage and ear exploration confirmed thick pus and granulations, with tissue analysis revealing acid-fast bacilli, Mycobacterium tuberculosis via GeneXpert, and granulomatous inflammation with caseous necrosis, confirming TB. The absence of BCG vaccination likely increased the infant’s susceptibility to this severe dual presentation. This case highlights the iagnostic challenges of extrapulmonary TB in children, often mistaken for bacterial infections, and underscores the critical role of BCG vaccination in preventing severe TB forms. It emphasizes the need for suspicion of TB in persistent head and neck infections, to ensure timely diagnosis and treatment.