Aim: Common causes of otalgia include otitis media, otitis externa, mastoiditis, bullous myringitis, and foreign bodies. Bullous myringitis is an inflammation of the tympanic membrane manifesting with fluid-filled blisters on its surface. The aim of this case presentation was to highlight the causes of otalgia and the importance of correct differential diagnosis of these different pathologies. In tropical countries, including Turkey, Malaysia, Sri Lanka and India, otoacariasis is a frequent cause of otalgia. Case report: We report a case of an 8-year-old girl presenting with left otalgia and low-grade fever. On examination, there was a vesicle on the tympanic membrane without pinna or tragal tenderness. The first attending physician misdiagnosed the patient as presenting with a tick on the tympanic membrane instead of bullous myringitis. She was referred to an otorhinolaryngology clinic for a tick on the tympanic membrane, where she received a revised diagnosis of bullous myringitis. The patient was treated with oral antibiotics and analgesics. She underwent regular followup, achieved a complete recovery and was discharged well. Conclusion: Early diagnosis and correct management are essential to ensure the most optimal outcome for patients.