Tuberculous otitis media is a relatively uncommon, approximately accounts for 0.05%–0.9% of chronic middle ear infections. It has been commonly seen in associated with or secondary to pulmonary tuberculosis. Clinical signs are often variable and different from classical descriptions. Therefore, laboratory studies are considered necessary for accurate diagnosis. Delayed diagnosis leads to delayed correct treatment, and followed by increased risk of complications such as permanent hearing loss or facial nerve palsy. In this report, we present a case of atypical tuberculosis manifestations after unsuccessfully long treating and excluding other infectious disorders of the ear. Biopsy during mastoidectomy procedure was performed for accurate diagnosis. Meanwhile, PCR result was negative for tuberculosis.
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