Epidemiological considerations and clinical features of ENT tuberculosis

Abstract

Between 1 April 1996 and 30 June 1997, 1003 ear, nose and throat (ENT) outpatients and 340 inpatients diagnosed as having pulmonary tuberculosis were analysed for ENT manifestations of tuberculosis to determine the relationship to sputum positivity, whether any high risk factors exist for the ENT manifestations as compared to other pulmonary tuberculosis patients, and the response to anti-tubercular treatment. The commonest ENT manifestation was found to be laryngitis (seven cases), which was more common in pulmonary tuberculosis patients (five out of seven), all except one of whom were sputum negative. All of these patients were defaulters from anti-tuberculosis treatment or relapse cases, and vocal cords were the commonest site of involvement. One case of tuberculous tonsillitis and one case of tuberculous mastoiditis were also noted. The practical implications of an awareness of ENT tuberculosis is a benefit of anti-tubercular therapy and hence conservative management usually suffices.

Tuberculose de orelha, doença profissional?

“…14 The clinical features have changed over the years. 7 It used to present as the triad: pain-free otorrhea, multiple tympanic membrane perforation, and peripheral facial palsy. Its current presentation has become polymorphic.…”

“…3 Factors that have led to an increased incidence of tuberculosis in past decades include: the increased prevalence of HIV infection; an increased incidence of people living in poor social and economic conditions; increased resistance to anti-tuberculosis therapy; the development of resistant bacilli; drug dependency; diabetes; and alcoholism. [3][4][5][6][7][8] In the head and neck tuberculosis affects mostly the larynx, and to a lesser degree, the middle and external ear, the tonsils, neck lymph nodes, the pharynx, the mouth and salivary glands. 4,7,8 In the beginning of the 20th century, tuberculosis caused 3% to 5% of chronic suppurative otitis media cases; this rate decreased with the advent of anti-tuberculosis therapy.…”

“…[3][4][5][6][7][8] In the head and neck tuberculosis affects mostly the larynx, and to a lesser degree, the middle and external ear, the tonsils, neck lymph nodes, the pharynx, the mouth and salivary glands. 4,7,8 In the beginning of the 20th century, tuberculosis caused 3% to 5% of chronic suppurative otitis media cases; this rate decreased with the advent of anti-tuberculosis therapy. 8,9 Its current frequency in developed countries ranges from 0.05 to 0.9% of the causes of chronic middle ear infection.…”

Tubercular laryngitis: case series

“…The most common infl ammatory lesion was tuberculosis (40%). Neeta Kulkarni et al (1996) [4] in an epidemiological and clinical study of ENT tuberculosis reported that the commonest presenting feature in all the patients was hoarseness. Similar conclusion was drawn by Essad M (2001) [5].The most common ENT manifestation of tuberculosis was tubercular laryngitis, which was more common in patients diagnosed of pulmonary tuberculosis especially defaulters of previous ATT therapy and relapse cases.…”

Tuberculosis in otolaryngological practice

“…3 Commonest manifestation of otolaryngological tuberculosis excluding cervical lympahedenitis is laryngitis, but a wide spectrum of cases is encountered now-a-days. 4 Here we present a series of cases of various manifestations of tuberculosis encountered in our ENT practice, commonest manifestation being cervical lymphadenopathy. The array includes number of presentations of lupus vulgaris of face, tuberculous infection of a preauricular sinus, tuberculous osteomyelitis of mastoid bone, laryngeal tuberculosis and many more varieties.…”