Diagnosis of miliary tuberculosis by examination of middle ear discharge

Extrapulmonary foci of tuberculosis appear more frequently than in previous years, while the incidence of tuberculous otitis, a neglected and often difficult to diagnose entity, is unknown. We describe a case of an adult with miliary tuberculosis not initially suspected on clinical criteria, in whom the diagnosis of miliary tuberculosis was made by inspection of a modified Kinyoun stain of occult ear discharge. The significance and diagnostic problems associated with tuberculous otitis are briefly reviewed.