Primary tuberculous otitis is a rare clinical entity and is usually difficult to diagnose. A delay in diagnosis can lead to fatal complications. Mycobacterium tuberculosis is the etiological agent in 0.1% of the cases of chronic otitis media. Case presentation: We report case of a child with tuberculous otitis media and cervical spinal involvement. The patient presented with painless purulent ear discharge, hearing loss and signs of meningeal irritation. The biopsy of specimen taken during the

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... astoidectomy procedure led to the diagnosis. Conclusion: Tuberculous otitis media is an indolent disease and can cause significant damage to middle ear and surrounding structures if left untreated. It is a diagnostic challenge and clinicians should be aware of similar association as it may result in delayed treatment with fatal consequences.