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THAI JOURNAL OTOLARYNGOLOGY HEAD NECK SURGERYVol 10 No.3 : July - Sep. 200933Laboratory studies revealed hematocrit of 35.9%, white blood cell was 11,400/mm 3 with 52%polymorphonuclear leukocytes, 18% lymphocyte, 15% monocyte and 14% eosinophils. The reticulonodularinfiltration of both lungs was demonstrated in chest X-Ray (Figure 3). Pus from left earwas sent for microbiology test. AFB stain was positive along with positive culture of Mycobacteriumtuberculosis after 50 days, The organism was sensitive to ethambutol, isoniazid, rifampicin, streptomycinand ofloxacin. PCR for TB DNA was negative. Histological findings of tissue from left earwere necrotic tissue and minimal granulation tissue with acute and chronic inflammation. Hemoculturewas no growth. Electromyography showed severe left facial neuropathy without reinnervation.Figure 3 : Chest X-Ray in this patient showing reticulonodular infiltration in both lungs.Computerized tomography of temporal bone revealed fluid filled in left mastoid and middle earwith multiple enhancing lesions in brain parenchyma. (Figure 4)Figure 4 : Computerized tomography of temporal bone.