Acute otitis media is a painful type of ear infection. It occurs when the area behind the eardrum called the middle ear becomes inflamed and infected. This patient’s middle ear infection was actually due to the infection of the nose and nasopharynx creeping up the Eustachian tube to infect the middle ear. Pus formed in the middle ear was almost on the verge of bursting th ear drum when patient came to seek medical treatment.