Tuberculosis can occur as pulmonary tuberculosis or as extrapulmonary tuberculosis. The commonest forms of extrapulmonary tuberculosis include the pleural tuberculosis and the lymph node tuberculosis. Here we are describing an interesting case of laryngeal tuberculosis which presented to us with odynophagia. The diagnosis was suspected on basis of chest x-ray and CT thorax, but it could only be confirmed after direct visualization of the larynx on fibreoptic bronchoscopy and by taking biopsy from the epiglottis under direct visualization.

Background: Early diagnosis of pulmonary tuberculosis is of utmost importance for proper control of the disease in the patient. Diagnosis of pulmonary tuberculosis is usually by acid fast bacilli (AFB) smear examination and culture Mycobacterium tuberculosis (MTB). In this study, we have employed polymerase chain reaction (PCR) for MTB in bronchoalveolar lavage (BAL) along with AFB smear and culture MTB for early diagnosis of pulmonary tuberculosis.Methods: A prospective observational study was conducted in the Department of Pulmonary Medicine, Era’s Lucknow medical college and Hospital, Lucknow over a period of two years. A total of 123 previously treated cases of pulmonary tuberculosis were enrolled for the study whose two sputum smear samples were negative for AFB. These patients underwent fibreoptic bronchoscopy and BAL was obtained which was sent for AFB smear, culture MTB and PCR for MTB.Results: The examination of BAL revealed the highest sensitivity for culture MTB at 87.4% followed by PCR for MTB at 73.8% and then AFB smear at 61.2%. PCR for MTB helped in diagnosing an additional 12% patients of pulmonary tuberculosis which were negative on AFB smear and an additional 6.8% patients which were negative on culture MTB.Conclusions: PCR for MTB is useful in making an early diagnosis of pulmonary tuberculosis especially in paucibacillary cases negative on AFB smear and also in some culture MTB negative patients.