tuberculous otomastoiditis
Introduction
Introduction to tuberculous otitis media After the discovery of Mycobacterium tuberculosis in 1882, the middle ear tuberculosis was diagnosed. More secondary to tuberculosis, the incidence rate was 13% at the beginning of the 19th century. In the past 20 years, the incidence of tuberculosis has been significantly reduced due to the availability of effective anti-spasmodic drugs. Tuberculous otitis media has rarely been seen. The most reported was Wang Pengwan in 41 cases in 1956. In the case of severe pulmonary tuberculosis, the painful running water in the ear was found, and then the infection became a thick pus. In the early stage, there were few tinnitus, deafness, gray edema on the surface of the tympanic membrane, erosion and necrosis in the tension, and multiple small perforations. Large perforation, the slack is rarely involved, and is different from general suppurative otitis media. basic knowledge The proportion of illness: 0.001% Susceptible people: infants and young children Mode of infection: non-infectious Complications: facial paralysis tuberculous meningitis
Cause
Causes of tuberculous middle ear mastoiditis
The bacteria-containing secretions enter the middle ear through the eustachian tube. Occasionally, the miliary tuberculosis can be infected into the middle ear through the blood. The newborn can be infected with the tuberculosis of the cattle due to the lax milk.
Prevention
Tuberculous otitis media prevention
Actively treat tuberculosis diseases and prevent the spread of tuberculosis.
1. Strengthen health education so that young people understand the harms and ways of infection of tuberculosis. Develop good health habits that don't spit. The TB patients are burned or disinfected.
2. Regular physical examination of adolescents should be carried out to achieve early detection, early isolation and early treatment. In addition, BCG vaccine should be given to infants and young children on time to make the body immune and reduce the occurrence of tuberculosis.
3. Found that there are symptoms such as low fever, night sweats, and blood clots in dry cough, so go to the hospital for examination. After the diagnosis of tuberculosis, it should be treated immediately with streptomycin, remi-salt, and ethambutol. At the same time, we must also pay attention to increase nutrition to enhance physical fitness. As long as it is found to be timely and completely treated, tuberculosis can be completely cured.
4. Tuberculosis is a disease transmitted by the tubercle bacillus through the respiratory tract. It is mainly transmitted by the patient's cough, sneezing and flying droplets when speaking loudly. Therefore, in order to avoid infection, it is necessary to develop good hygiene habits. When sneezing, use a handkerchief to cover your mouth and avoid facing others; the room should be ventilated frequently, and people in densely populated areas should pay more attention; more exercise should be done to improve immunity.
Complication
Tuberculous otitis media Complications , tuberculous meningitis
The pus is a long time, the hearing is quickly lost, and the facial paralysis and the posterior tibial fistula often occur. The incidence of facial paralysis accounts for 20%, especially in children. It is a characteristic of tuberculous otitis media. Intracranial complications are rare. Tuberculous meningitis.
Symptom
Tuberculous middle ear mastoid inflammation symptoms Common symptoms secondary infection of ear mites ear long ear tinnitus ear edema edema mastoid inflammation ear tympanic membrane perforation ear lymphadenopathy
In the case of severe pulmonary tuberculosis, the painful running water in the ear was found, and then the infection became a thick pus. In the early stage, there were few tinnitus, deafness, gray edema on the surface of the tympanic membrane, erosion and necrosis in the tension, and multiple small perforations. Large perforation, the slack is rarely involved, and is different from general suppurative otitis media.
Examine
Tuberculosis otitis media examination
Early examination: hyperemia of the tympanic membrane, blood vessels around the tension and the radial expansion of the hammer stem. This period is often overlooked, especially in children.
Mid-term examination: diffuse hyperemia of the tympanic membrane, accompanied by swelling, bulging outward, first seen in the posterior upper part. Afterwards, all of them are convex. The normal sign is difficult to identify. Blood: The total number of white blood cells increases, and the proportion of neutrophils increases.
Late examination: Before the perforation of the tympanic membrane, small yellow spots appear first. The beginning of the perforation is generally very small, and it is not easy to see. After thoroughly cleaning the external auditory canal, the highlight of the tympanic membrane is flashing and there is pus from the place (ear). Hearing tests are conductive.
Recovery period check: visible small perforation in the tympanic membrane, purulent secretion in the external auditory canal or dry.
Other tests: including tuberculosis, ct, and PPD, etc.
Diagnosis
Diagnosis and diagnosis of tuberculous otitis media
diagnosis
Have a history of tuberculosis, positive tuberculosis test in children, tuberculosis can be found in ear secretions.
Differential diagnosis
(1) External auditory canal inflammation and edema, diffuse swelling in the external auditory canal and ear canal, exudation of pulpy secretions, late limitation of edema and pus, secretion without mucus, deafness is not characteristic. Pressing the tragus is painful, and the lymph nodes are often swollen after the ear.
(B) acute tympanitis, often complicated by influenza and herpes zoster, tympanic membrane congestion forming a cannon, severe ear pain, but no perforation and pus, hearing loss is not heavy, blood leukocytes do not increase.
