Question:medium
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: Seeing several discrete holes in one tympanic membrane, rather than a solitary perforation, is the key clue and points to tuberculosis of the middle ear.
Step 2: Tubercles seeded in the middle ear mucosa caseate and rupture, so the drum is breached at multiple points. The discharge is classically thin and painless.
Step 3: The organism usually ascends via the eustachian tube; uncommonly it arrives by blood from a lung or lymph node focus or through unpasteurised cow's milk. Children and young adults are most often affected.
Step 4: Syphilitic, pseudomonas and fungal ear disease do not produce this multiple perforation pattern, so they are ruled out.
\[\boxed{\text{Tubercular Otitis Media}}\]
Step 2: Tubercles seeded in the middle ear mucosa caseate and rupture, so the drum is breached at multiple points. The discharge is classically thin and painless.
Step 3: The organism usually ascends via the eustachian tube; uncommonly it arrives by blood from a lung or lymph node focus or through unpasteurised cow's milk. Children and young adults are most often affected.
Step 4: Syphilitic, pseudomonas and fungal ear disease do not produce this multiple perforation pattern, so they are ruled out.
\[\boxed{\text{Tubercular Otitis Media}}\]
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