Question:
A patient presented with the following picture of the tympanic membrane. What is the most probable diagnosis (marked with the arrow)?
A patient presented with the following picture of the tympanic membrane. What is the most probable diagnosis (marked with the arrow)?
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Multiple perforations of the tympanic membrane point to a specific granulomatous infection.
Updated On: Jun 23, 2026
- Tubercular Otitis Media
- Syphilitic Otitis Media
- Pseudomonas infection
- Fungal Otitis Media
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The Correct Option is A
Solution and Explanation
Step 1: The image shows a tympanic membrane with multiple perforations and associated otorrhea. Multiple perforations together with painless otorrhea strongly suggest tuberculous otitis media.
Step 2: In tuberculous otitis media these perforations result from the breaking down of tubercles in the middle ear mucosa, which then coalesce. Infection usually reaches the middle ear through the eustachian tube.
Step 3: Rare routes include hematogenous spread from a pulmonary, tonsillar or cervical lymph node focus, or ingestion of infected cow's milk. It commonly affects children and young adults.
Step 4: A single central perforation is typical of ordinary chronic otitis media; pseudomonas and fungal infections do not characteristically give multiple perforations. Hence the diagnosis is tubercular otitis media.
Step 2: In tuberculous otitis media these perforations result from the breaking down of tubercles in the middle ear mucosa, which then coalesce. Infection usually reaches the middle ear through the eustachian tube.
Step 3: Rare routes include hematogenous spread from a pulmonary, tonsillar or cervical lymph node focus, or ingestion of infected cow's milk. It commonly affects children and young adults.
Step 4: A single central perforation is typical of ordinary chronic otitis media; pseudomonas and fungal infections do not characteristically give multiple perforations. Hence the diagnosis is tubercular otitis media.
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