Primary tonsillar tuberculosis masquerading as carcinoma of the tonsil

Tisekar, Owais; Bhaskar, Maheema; Biraris, Pavankumar; Epari, Sridhar; Tandon, Sandeep

doi:10.1016/j.ijtb.2019.11.014

Cited by 4 publications

(6 citation statements)

References 5 publications

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“…Treatment of primary tonsillar tuberculosis consists of antituberculous therapy, 6 months of standard anti-tuberculous regimen. [4,6] Although due to the atypical clinical appearance there is a delay in treatment initiation, there is a general good outcome when treated. [7] Unlike its pulmonary form, tonsillar tuberculosis is a multidrug-resistant TB strain free, no case being reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the general immune-suppressing conditions known to influence the incidence of TB in its pulmonary form, poor oral hygiene, periodontitis, dental extraction and leukoplakia seem to be predisposing factors for tuberculous tonsillitis [5] . Its primary form is presented only as a tonsillar involvement without pulmonary touch [6] . Medical history and clinical examination may raise the suspicion of tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

“…TST and IGRA provide evidence for infection but for confirmation, histological examination, Ziehl Neelsen staining, and mycobacterial culture must be done. Treatment of primary tonsillar tuberculosis consists of antituberculous therapy, 6 months of standard anti-tuberculous regimen [4,6] . Although due to the atypical clinical appearance there is a delay in treatment initiation, there is a general good outcome when treated [7] .…”

Section: Discussionmentioning

confidence: 99%

“…[5] Its primary form is presented only as a tonsillar involvement without pulmonary touch. [6] Medical history and clinical examination may raise the suspicion of tuberculosis. TST and IGRA provide evidence for infection but for confirmation, histological examination, Ziehl Neelsen staining, and mycobacterial culture must be done.…”

Section: Discussionmentioning

confidence: 99%

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Primary tonsillar tuberculosis in a pediatric patient

Moisă¹,

Miron²,

Adam-Raileanu³

et al. 2021

Medicine

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Rationale:Tuberculosis is an entity that usually affects the lungs, although extrapulmonary sites can also be involved. Tonsils are rarely affected, especially in the absence of pulmonary disease, primary tonsillar tuberculosis being a diagnostic challenge for the clinician.Patient concerns:We present the case of a 14-year-old female teenager, presented to our Pediatric Service with a 14-day history of dysphagia, odynophagia and left reflex otalgia associated with a 5 kg weight loss. Clinical examination revealed mild pharyngeal erythema, marked enlargement of the left tonsil infiltrating the lateral pharyngeal wall and the uvula and painful, mobile, nonadherent to deep bilateral latero-cervical adenopathy.Diagnosis:Positive interferon-gamma release assay (QuantiFERON-TB gold). Mantoux test reading was 16 mm.Interventions:During hospitalization, the patient received Clindamycin and Gentamicin for 3 days i.v., with discrete relief of symptoms and inflammatory markers. On the 4th day of hospitalization, treatment with Imipenem/Cilastin is started for 7 days in micro-perfusion, with tonsil hypertrophy decrease in size and favorable clinical evolution.Outcome:Tonsil hypertrophy decreased in size and patient had a favorable clinical evolution. At discharge, the patient was given a 6-month course of anti-tuberculous drug.Lessons:The particularity of this case is represented by the rarity of primary tuberculosis of tonsils in children, with unilateral involvement, displaying at the same time a common issue encountered in the current practice: the limitations and the difficult course of setting the diagnosis due to the involvement of relatives in the medical act.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Primary tonsillar tuberculosis in a pediatric patient

Moisă¹,

Miron²,

Adam-Raileanu³

et al. 2021

Medicine

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show abstract

“…4,5 However, FDG PET/CT image of tuberculosis in various sites may be misdiagnosed as malignant tumor. [6][7][8][9] Wang et al 10 reported a case of primary chest wall tuberculosis presenting as intense FDG uptake in the posterior pleural mass and adjacent muscle without rib involvement mimicking a malignancy. The patient in our case had simultaneous rib, muscle, and diaphragm invasion.…”

Section: Figurementioning

confidence: 99%