Persistent tinnitus preceded diagnosis of multifocal tuberculosis in a 32-year-old patient: case report

A 32-year-old patient with diabetes and no known history of tuberculosis sought care for three months of isolated, persistent tinnitus without associated respiratory signs, according to a case report in BMC Infectious Diseases. The initial ear, nose and throat examination was unremarkable, but the condition later progressed to include left-sided hearing loss, facial and upper-limb paresthesia, nocturnal fever and deterioration in general condition.

Diagnostic imaging identified several affected anatomical sites. Brain MRI showed a left otomastoid abscess alongside necrotic thalamic and mesencephalic lesions considered suggestive of tuberculomas. Chest, abdominal and pelvic CT revealed diffuse pulmonary miliary tuberculosis, mediastinal lymphadenopathy and enlarged adrenal glands. A sputum GeneXpert MTB/RIF test was positive for Mycobacterium tuberculosis, leading to a diagnosis of multifocal tuberculosis involving the lungs, nervous system, ear, nose and throat, and adrenal glands.

The authors described the case as an unusual presentation of disseminated tuberculosis. The abstract notes that tinnitus is an uncommon manifestation and reports that there were no previously described cases in which persistent isolated tinnitus was the initial symptom of multifocal tuberculosis. In this case, tinnitus preceded the appearance of other neurological, sensory and systemic findings, including left-sided hearing loss, paresthesia, fever and worsening general condition.

Following diagnosis, the patient received four-drug antituberculosis therapy, and the report stated that clinical progress was favorable. Because the evidence comes from a single case report, the observation does not establish how frequently multifocal tuberculosis presents with tinnitus or whether the same clinical course can be expected in other patients. The authors concluded that persistent unexplained tinnitus may warrant consideration of a systemic infectious cause, particularly in settings where tuberculosis is endemic, and emphasized the role of molecular testing in early diagnosis.

Subject of Research: A case report of multifocal tuberculosis initially revealed by persistent tinnitus

Article Title: Tinnitus revealing a multifocal tuberculosis: a case study

Article References: Qadiri, K., Belhajou, L., Azouzou, K., Lahlou, Y. B., Benaissa, E. M., & chadli, M. (2026). Tinnitus revealing a multifocal tuberculosis: a case study. BMC Infectious Diseases. https://doi.org/10.1186/s12879-026-14239-w

Image Credits: AI Generated

DOI: 10.1186/s12879-026-14239-w

Keywords: tinnitus, multifocal tuberculosis, case report, miliary tuberculosis, tuberculomas, otomastoid abscess, hearing loss, GeneXpert, revealing, multifocal, tuberculosis, case