An unusual presentation: Primary tuberculosis of the middle ear cleft

Tuberculosis rarely affects the middle ear cleft; therefore, except for those working in close association with respiratory physicians, the disease is a curiosity and not often considered in the differential diagnosis of otorrhea. The diagnosis is thus made too late, with resulting complications such as irreversible hearing loss and facial nerve paralysis. A case report and review of the literature are presented, emphasizing that tuberculosis should be considered in the differential diagnosis of chronic ear infection.