ABSTRACT
@#<p style="text-align: justify;"><strong>OBJECTIVE</strong>: The aim of this report is to describe an aggressive case of tuberculous otitis media in a young child and emphasize that surgical intervention and histopathologic studies can be employed to immediately arrive at a definitive diagnosis.</p><p style="text-align: justify;"><strong>METHODS:</strong></p><p style="text-align: justify;"><strong> Design:</strong> Case Report</p><p style="text-align: justify;"><strong> Setting: </strong>Tertiary Government Training Hospital</p><p style="text-align: justify;"><strong> Participants:</strong> One</p><p style="text-align: justify;"><strong>RESULTS</strong>: This is a case of a four-year-old boy who had refractory otitis media and erosive CT scan findings, mimicking aggressive CSOM manifestations. Due to unusual intraoperative granulation tissue characteristics, it was initially considered a malignancy, necessitating surgical intervention and biopsy that resulted in a definitive diagnosis of primary middle ear tuberculosis.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> This case represents the more severe end of the spectrum of tuberculous otitis media and supports the recommendation that a high index of suspicion, early detection, and prompt initiation of treatment are imperative in its management, especially in children with refractory otitis media.</p><p><strong> </strong></p>