Annals of Tropical Paediatrics (2003) 23, 51–54 Facial paralysis caused by tuberculosis in a 2.5-month-old infant EMBIYA DILBER, NILGU ¨ N YARIS ¸ , YAKUP ASLAN, MUKADDES KALYONCU, ALI AHMETOG Æ LU* & AYS ¸ ENUR O ¨ KTEN Departments of Pediatrics and *Radiology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey (Accepted October 2002) Summary We describe an infant who presented with a cervical mass and ear discharge that did not respond to broad-spectrum antibiotics. Tuberculous infection was diagnosed after the onset of respiratory distress. Persistent otorrhoea that does not respond to conventional antibiotics or facial paralysis in a child with a discharging ear should alert the physician to a diagnosis of tuberculosis. Introduction spectrum antibiotics given intravenously, the swelling continued to enlarge, and fever, Tuberculous lesions of the skull and head respiratory distress and right facial paralysis are relatively rare. 1 –5 They can occur as a ensued. A chest X-ray done at that time localised primary infection or secondary showed bilateral pulmonary in ltration to generalised tuberculous infection. Facial (Fig. 1) and she was then referred to our paralysis owing to tuberculous infection is hospital. now very rare in the western world and On admission, the infant was irritable the few cases reported have been secondary and a smooth, rm, right cervical mass, to tuberculous parotitis or tuberculous 3 ×5-cm, was noted, as was right facial palsy mastoiditis. 5 We describe an infant with and purulent discharge from the right ear. cervical tuberculosis and mastoiditis who Chest auscultation revealed bilateral ne developed facial paralysis. rales and the liver was palpated 3 cm below the right costal margin. The blood counts were normal. She had not received BCG immunisation and a Mantoux skin test was Case Report negative. The family history revealed that an aunt had been receiving treatment for tuber- A 2.5-month-old baby girl presented with a culosis for the past 2 months. Radiological 3-week history of right cervical swelling and imaging of the neck revealed a mass on ear discharge. Despite treatment with broad- the right side that in ltrated the temporal bone and caused contrast accumulation and Reprint requests to: Dr Embiya Dilber, Division of meningeal thickening at the base of the Cardiology, Department of Pediatrics, Hacettepe middle cranial fossa (Fig. 2). University Faculty of Medicine, 06100 Ankara, Turkey. The mass was surgically removed and Fax: +90 312 309 0220; e-mail: embiyadilber@ yahoo.com histological examination revealed caseous © 2003 The Liverpool School of Tropical Medicine DOI: 10.1179/000349803125002878