Primary Tuberculosis of Middle Ear

Primary Tuberculosis of the middle ear remains a diagnostic challenge due to unspecific and variable clinical presentations.A characteristic clinical triad of painless ear discharge, multiple perforations and pale granulations in middle ear cleft is often seen but maybe absent.We report the case of a 10 year old girl who presented with bilateral ear discharge with attic involvement and facial palsy to otolaryngology department of our hospital.Surgical findings revealed pale granulations in mastoid and middle ear.Histopathological and microbiological examination of excised tissue showed the presence of acid fast bacilli.There was no evidence of pulmonary or any other tubercular foci.