Mumbai: A rare medical case has emerged from Bhandup involving a 34-year-old woman, Gauri Sable (name changed), who experienced persistent pain and swelling in her left ear for 3 to 4 days. Despite initial treatment with oral antibiotics prescribed by Dr. Sheetal Radia, an ENT surgeon, her condition worsened. The increasing swelling led to her referral to Dr. Hardik Thakker, an MD Physician and Infectious Disease Specialist at Apex Hospitals, Mulund.
Dr. Hardik Thakker and his medical team promptly admitted the patient due to significant peri-orbital swelling. “Given the extent of the swelling, we opted for IV antibiotics and other supportive treatments,” Dr. Thakker explained. To further investigate the cause, an MRI scan of the brain and orbital region was conducted, followed by surgical drainage of pus, which was sent for laboratory analysis.
The tests unveiled a surprising diagnosis: the infection was caused by atypical tuberculosis (TB) bacteria, marking an extremely rare occurrence. According to Dr. Thakker, “This is the first case of its kind we have encountered in Mumbai, with only a few similar cases reported in Malaysia and none in India to date.” Atypical mycobacteria, also known as nontuberculous mycobacteria (NTM), are known to cause a variety of health issues, including skin and soft tissue infections, lymphadenitis, pulmonary conditions, disseminated infections, and other rare presentations.
Following the diagnosis, the medical team initiated a treatment regimen comprising three anti-TB medications. Within three days of this targeted therapy, Gauri Sable’s condition improved significantly, allowing for her discharge. Dr. Thakker confirmed, “She responded well to the treatment and has been doing well since then.”
This case underscores the importance of recognizing rare infections in clinical practice, particularly when standard treatments fail. Nontuberculous mycobacterial infections, though uncommon, can present serious challenges due to their varied manifestations and resistance to typical treatment protocols. The successful management of this case at Apex Hospitals highlights the critical role of multidisciplinary approaches and advanced diagnostic tools in handling complex medical scenarios.
The rarity of such cases in India emphasizes the need for heightened awareness among medical professionals to ensure timely diagnosis and treatment of atypical infections. Gauri Sable’s case serves as a reminder of the evolving landscape of infectious diseases and the importance of expertise in identifying and managing unusual presentations.