Rediscovering tuberculosis of the middle ear

Tuberculous otitis media (TOM) has no specific clinical presentation. Early diagnosis is necessary in order to avoid serious complications. The aim of this paper is rediscovering this rare forgotten disease that can re-emerge in a globalized society. A case of a 37 year-old woman with persistent unilateral otitis media with ear discharge and deafness since two years is presented. Systemic and topic antibiotic therapy was not effective. She underwent surgery twice with no improvement. As clinical conditions worsened, she was hospitalized. Histological examination and culture for mycobacteria detection revealed Mycobacterium tuberculosis complex infection. The patient was treated with anti-tuberculosis medical therapy for 9 months with clinical improvement. TOM is a diagnostic challenge and is often treated late because not suspected. Chronic otitis media not responding to common antibiotics should be investigated for tuberculous infection.