BMJ Case Reports 2018; doi:10.1136/bcr-2017-222482
  • Unusual association of diseases/symptoms

Atypical presentation of aural tuberculosis with complication

  1. Alok Thakar2
  1. 1Department of ENT, All India Institute of Medical Sciences, New Delhi, India
  2. 2Department of ENT and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr David Victor Kumar Irugu, drdvki2776{at}
  • Accepted 14 February 2018
  • Published 9 March 2018


Tuberculosis involving mastoid and ear is an uncommon entity presenting with myriads of non-specific features and difficult to diagnose, being a paucibacillary condition. The involvement of otomastoid compartment is hypothesised to be of haematogenous origin. Rarely it can spread directly via tympanic membrane perforation or via reflux through eustachian tube. The usual picture of presentation tends to be one of indolent ear infection not responsive to usual antibiotic treatment and symptomatology being out of proportion to examination findings. We present a case of aural tuberculosis presenting with zygomatic and Bezold abscess without other symptoms, and the usefulness of GeneXpert test in mycobacterial detection in such paucibacillary conditions.


  • Contributors AS, DVKI, HV and AT fulfil the below requirements of authorship for the manuscript: (1) substantial contributions to the conception or design of the work (AS, DVKI, HV and AT) and aquisition of data (AT). (2) Drafting the work (AT and DVKI) and revising it critically (HV and AT) for important intellectual content. (3) Final approval of the version published (AS, DVKI, HV and AT). (4) All of the authors (AS, DVKI, HV and AT) hold accountability for accuracy and integrity of the work.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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