Clinical Case of Temporal Bone Tuberculosis at Drug-Resistant Tuberculosis/HIV Co-Infection: Risk Factors, Features of Clinical Course, Treatment and Outcomes

Abstract

Our own observation of a case of temporal bone tuberculosis in a patient with co-infection of drug-resistant tuberculosis/HIV infection is presented. The aim of the work was to identify risk factors, features of the clinical course, treatment and outcomes of temporal bone tuberculosis at drug-resistant tuberculosis/HIV co-infection. Analysing the clinical case, we found the following features. Injection drug addiction, self-interrupted treatment of drug-resistant tuberculosis and irregular antiretroviral therapy (ART) intake were risk factors for temporal bone tuberculosis (otitis media, mastoiditis) in the presented case. The lack of information among otolaryngologists about drug-resistant tuberculosis with bacterial excretion in the patient caused a lack of vigilance regarding the tuberculous nature of chronic epitympanic-antral purulent otitis media, which led to late diagnosis and the development of an advanced form of temporal bone tuberculosis (otitis media, mastoiditis) and Bell’s palsy. The development of tuberculosis of the temporal bone (otitis media, mastoiditis) and the formation of a fibrocavernous form of a specific process in the lungs were outcomes of interrupted treatment for drug-resistant tuberculosis and irregular ART intake in case of drug-resistant tuberculosis/HIV co-infection. The features of the temporal bone tuberculosis clinical course in case of drug-resistant tuberculosis/HIV co-infection were the appointment of correct comprehensive treatment, which contributed to the cessation of bacterial excretion after 4 months, positive clinical and laboratory dynamics and healing of temporal bone tuberculosis.