Mycobacterial Preauricular Sinus Abscess: A Case Series

Preauricular sinus is a common congenital external ear anomaly. It occurs due to the incomplete fusion of hillocks of His of the first and second branchial arches. Tuberculosis (TB) is endemic in Malaysia, which imposes a major public health problem. It is caused by Mycobacterium tuberculosis, which causes chronic, recurrent diseases and poor healing of a wound. Pulmonary TB is the most common form of infection, some manifesting as extrapulmonary TB. We share our experience in managing a series of three patients with recurrent tuberculous preauricular sinus abscesses in different age groups. Testing for acid-fast bacilli is highly advocated in recurrent cases and in extensive infection of preauricular sinuses despite the absence of systemic or pulmonary symptoms. Treatment with anti-tuberculous drugs is commenced, followed by an elective sinus excision once the patient is free from infection to prevent recurrence.