Encephalopathy due to tubercular otitis media

Area of Science:

• Otolaryngology
• Infectious Diseases
• Neurology

Background:

• Effective anti-tuberculosis therapy has significantly reduced the incidence of tuberculous otitis media from 3-5% to 0.05-0.9% over the past century.
• The decline in tuberculous otitis media frequency, coupled with overlapping symptoms with common non-tuberculous otitis media, poses diagnostic challenges for clinicians.

Observation:

• A case of tuberculous otitis media presented with atypical clinical manifestations.
• The patient exhibited signs of encephalopathy, an unusual presentation for this condition.

Findings:

• The case highlights the potential for tuberculous otitis media to present with non-specific or atypical symptoms.
• Delayed or misdiagnosis can occur due to the similarity in signs and symptoms with more common forms of otitis media.

Implications:

• Clinicians should maintain a high index of suspicion for tuberculous otitis media, even with atypical presentations.
• Awareness of rare but serious conditions like tuberculous otitis media is crucial for timely and accurate diagnosis and treatment.
• This case underscores the importance of considering tuberculosis in the differential diagnosis of otitis media, especially when accompanied by neurological symptoms.