PT - JOURNAL ARTICLE AU - Anup Singh AU - David Victor Kumar Irugu AU - Hitesh Verma AU - Alok Thakar TI - Atypical presentation of aural tuberculosis with complication AID - 10.1136/bcr-2017-222482 DP - 2018 Mar 09 TA - BMJ Case Reports PG - bcr-2017-222482 VI - 2018 4099 - http://casereports.bmj.com/content/2018/bcr-2017-222482.short 4100 - http://casereports.bmj.com/content/2018/bcr-2017-222482.full AB - 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.