Co-infection with Neisseria mucosa in a patient with tuberculous otitis media  

作　　者：Tatsuya Hioki Kazuaki Soejima Yuki Goto Makoto Sugiura Takumi Umemura Yoshimi Ishihara Yoshikazu Mutoh Daisuke Sakanashi Hiroshige Mikamo 

机构地区：[1]Department of Clinical Laboratory,Tosei General Hospital,160 Nishioiwake-cho,Seto,Aichi,489-8642,Japan [2]Department of Respiratory Medicine and Allergy,Tosei General Hospital,160 Nishioiwake-cho,Seto,Aichi,489-8642,Japan [3]Department of Otolaryngology,Tosei General Hospital,160 Nishioiwake-cho,Seto,Aichi,489-8642,Japan [4]Department of Infection Control Team,Tosei General Hospital,160 Nishioiwake-cho,Seto,Aichi,489-8642,Japan [5]Department of Infectious Diseases,Tosei General Hospital,160 Nishioiwake-cho,Seto,Aichi,489-8642,Japan [6]Department of Infection Prevention and Control,Aichi Medical University Hospital,1-1 Yazakokarimata,Nagakute,Aichi,480-1195,Japan [7]Department of Clinical Infectious Diseases,Aichi Medical University,1-1 Yazakokarimata,Nagakute,Aichi,480-1195,Japan

出　　处：《Journal of Otology》2024年第1期1-4,共4页中华耳科学杂志（英文版）

摘　　要：Tuberculous otitis media(TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal Neisseria. Thus, understanding the pathogenic mechanisms and clinical features of commensal Neisseria is important, considering its recent presentation as an infection-causing pathogen. Neisseria mucosa is a commensal inhabitant in humans and is generally considered non-pathogenic but can cause infection in rare cases. Here, we report an atypical secondary infection caused by Neisseria mucosa in an 81-year-old woman with TOM being treated for pulmonary tuberculosis. Direct purulent otorrhea smear microscopy revealed no acid-fast bacilli using Ziehl-Neelsen staining, whereas the phagocytosis of gram-negative cocci by white blood cells was confirmed using Gram staining. Otorrhea culture revealed the growth of N. mucosa. Subsequently, M. tuberculosis infection in the otorrhea was identified using a culture-based method. Vigilance is critical for the early detection of TOM to prevent further complications. This report raises awareness regarding TOM and provides insight into the pathogenicity of N. mucosa in otitis media.

关 键 词：Commensal neisseria Miliary tuberculosis Mycobacterium tuberculosis Neisseria mucosa Tuberculous otitis media 

分 类 号：R764.21[医药卫生—耳鼻咽喉科] R529.8[医药卫生—临床医学]