An 8-year-old child presents with painless, odourless ear discharge of 4 months duration and firm, non-tender cervical lymph nodes. Otoscopy shows two perforations in the same tympanic membrane with pale granulations in the middle ear. The most likely diagnosis is:
- A Malignant otitis externa
- B Atticoantral chronic suppurative otitis media
- C Tuberculous otitis media ✓
- D Wegener's granulomatosis of the ear
Correct answer: C. Tuberculous otitis media
Explanation
Tuberculous otitis media classically presents with painless, scanty discharge and MULTIPLE perforations in one tympanic membrane, unlike the single central perforation of bacterial tubotympanic disease. Associated painless cervical lymphadenopathy and pale granulation tissue support the diagnosis. Granulations are typically pale rather than the red polypoidal tissue of bacterial disease. Confirmation requires culture for acid-fast bacilli, PCR, or histopathology showing caseating granulomas.
Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.