Prolonged otorrhea and mastoiditis caused by Mycobacterium abscessus

Infections caused by nontuberculous mycobacteria (NTM) have been reported increasingly. Rarely, NTM also cause chronic ear infections. We describe Mycobacterium abscessus mastoiditis in an immunocompetent child, whose painless chronic otorrhea failed to settle with routine antimicrobial and local therapy. Polyps and granulation tissue were noted on the tympanic membrane. The diagnosis was made with staining on acid-fast bacilli and culture of mycobacteria in biopsy material. The successful treatment consisted of surgery, removal of foreign material (tympanostomy tube), and antimicrobials. Chronic otorrhea unresponsive to standard therapy can be caused by NTM and should be examined for the presence of acid-fast bacilli.