Abstract

Tuberculosis of the middle ear and temporal bone are rare and accounts for only 0.05 - 0.9% of all cases of all chronic otitis media. We present a rare case report of a 10-year-old boy with a right chronic febrile otomastoiditis misdiagnosed and treated as meningitis given its high temperature without improvement. Examination found post-aural ulceration with bare bone sequestrum and a total perforation of the tympanic membrane on otoscopy. Audiometry indicated a 70 db conductive hearing loss in the right ear with airbone gap of 50 db. CT scan of temporal bone showed an extensive bone lysis of the mastoid and the middle stage of the skull base. The pathological examination of the granulomatous tissue biopsy during the mastoid surgery, revealed tuberculous granulomatous inflammation with necrosis that was consistent with progressive tuberculosis. The patient was treated accordingly with a remarkable improvement. The diagnosis of tuberculosis should be kept in mind in case of a chronic otitis media, especially in endemic countries.

Keywords: Tuberculous Otitis Media (TOM); Children; Otomastoiditis

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