Unusual protracted course of non-tuberculous mycobacterium otomastoiditis in a child

Summary 

Mycobacterium chelonae, one of the rapidly growing non-tuberculous mycobacteria, is a rare but increasingly recognized cause of otomastoiditis. Recently, we have experienced an unusual protracted course in a 6-year-old girl with acute otomastoiditis on the left ear caused by M. chelonae, 8 months after ventilation tube insertion. During 142 consecutive admission days, she was treated with repeated surgical interventions coupled with long-term administration of antimicrobial agents. One year after discharge, she was rather well without recurrent otorrhea. In conclusion, when a child with intractable draining ear after ventilation tube insertion, unusual pathogen, e.g. M. chelonae should be taken into consideration, which deserves further confirmation. Subsequently, surgical intervention coupled with prolonged antibiotic treatment is essential to eradicate the infectious foci from middle ear and mastoid cleft.

Keywords: Non-tuberculous mycobacterium, Mycobacterium chelonae, Mastoiditis, Ventilation tube