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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr0220102721.
Published online Dec 2, 2010. doi:  10.1136/bcr.02.2010.2721
PMCID: PMC3027601
Unusual presentation of more common disease/injury
Tuberculous otitis media: a case presentation and review of the literature
S K Aremu1 and B S Alabi2
1Department of Otolaryngology, University of Ilorin Teaching Hospital, Ilorin, Nigeria
2ENT Department, University of Ilorin Teaching Hospital, Ilorin, Nigeria
Correspondence to S K Aremu, shuaib.aremu/at/gmail.com
Abstract
A 42-year-old farmer being treated for pulmonary tuberculosis was referred to our clinic after developing otorrhoea and hearing loss in his right ear. Examination revealed a large subtotal perforation in the right ear in addition to a purulent discharge with right facial nerve palsy. Audiometry indicated a 35 dB conductive hearing loss at 0.5, 1 and 2 kHz with air–bone gaps of 12, 15 and 10 dB, respectively. A middle ear biopsy was performed under direct visualisation, with a middle ear lavage which was positive for allergic fungal sinusitis (AFS). The final diagnosis was tuberculous otitis media (TOM).
Clinical symptoms and signs should be reviewed in every case of chronic otitis media keeping the possibility of tuberculosis in mind. Otorrhoea in a patient with known or suspected active pulmonary tuberculosis should be assumed to be TOM until proven otherwise.
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