A 31-year-old man with bi...

A previously healthy 31-year-old man visited the emergency room with bilateral facial paralysis, an inability to close his eyes, and a history of ear pain and left ear discharge. He had no previous fever, infection, trauma, or surgery. His vital signs were typical, and he had a positive Bell's phenomenon and a masked face, as shown in Figure 1. ENT examination showed left ear discharge and a small central perforation, while the right ear had a retracted tympanic membrane and myringitis. Routine blood tests revealed an elevated white blood cell count and neutrophil count. CT scans showed chronic sinusitis and fluid buildup in the middle ear. The patient was diagnosed with Mycobacterium tuberculosis and started on antitubercular treatment, which gradually improved his facial palsy and ear discharge. After four months, he fully recovered and had no residual facial paralysis.