The application of metagenomic next generation sequencing in diagnosing tuberculous otitis media: a case report and review of the literature.

BACKGROUND

Tuberculous otitis media is a chronic Mycobacterium tuberculosis infection of the middle ear tissues. Diseases with varied and insidious clinical features can make diagnosis difficult and delay treatment.

CASE PRESENTATION: Here, we document a case of tuberculous otitis media in a 46-year-old ethnic Han woman that manifested as nonspecific chronic otitis media. A mastoidectomy and tympanoplasty were performed for the initial diagnosis of cholesteatoma. The histopathology of the tissue specimen revealed granuloma formation with necrosis. Staining for acid-fast bacilli and the polymerase chain reaction method for Mycobacterium tuberculosis yielded negative results. However, the chest computed tomography scan demonstrated a pulmonary miliary nodule. Next, metagenomic next-generation sequencing was applied and the Mycobacterium tuberculosis was identified. The patient recovered after receiving antituberculous treatment.

CONCLUSION

This report highlights the application of novel diagnostic tools such as metagenomic next-generation sequencing as a supplementary method for the diagnosis of tuberculous otitis media in highly suspected patients.