Some Manifestations of Tuberculosis in Otorhinolaryngology – Case Series and a Short Review of Related Data from South-Eastern Europe

Abstract

Tuberculosis is a disease of global outreach that may affect the entire human body but is most commonly located in the lungs. Otorhinolaryngological manifestations of tuberculosis are rare, mostly occurring secondary to pulmonary disease but nevertheless represent significant diagnostic challenges. Nasopharyngeal tuberculosis is rare, representing around 1% of all upper air-way localizations and the most common presentation is in the form of adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. We present four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid occurrence of complications.

Extraganglionary Localization of Tuberculosis in Otorhinolaryngology: Rare Presentations About 29 Cases

“…Lingual trauma, carious teeth and smoking are known to favor tuberculosis infection. On the other hand, the environment of the oral cavity is hostile for the multiplication of BK: unfavorable local pH, the salivary flow and the paucity of lymphatic tissue 1,2 . Clinically, oral tuberculosis can present in several ways.…”

“…The typical tuberculous ulcer, often unique, occurs in a known tuberculosis patient. A tuberculoma, a chronic glossitis or an indurated lesion under the mucosa are possible [1][2][3] . In our series, we observed a case of non-hemorrhagic ulceration of the hard palate whose biopsy confirmed the diagnosis.…”

“…Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis or bacillus Koch (BK), which mainly affects the lungs; however, extrapulmonary locations can occur in one-third of cases 1 . Cervical lymph node involvement is the most common extrapulmonary location and it's mostly represented by the lymph node localisation 2 . Extranodal ear, nose, and throat (ENT) sites are rare and are dominated by laryngeal localization 3 .…”

“…Extranodal ear, nose, and throat (ENT) sites are rare and are dominated by laryngeal localization 3 . The diagnosis is hard to suspect and, given the clinical polymorphism, it could be hard to assess by clinicians if it is not considered, leading to multiple complications and sequelae that could be prevented by an early diagnosis assessment and treatment by chemotherapy [2][3][4] . Thus, the importance of our study where we describe the epidemiological, clinical, therapeutic, and evolutionary profile of rare extra-nodal ENT tuberculosis localizations.…”

“…M:Male; F: Female; Unk: Uknown;ND: Not Done; R:Rifampicin, H: isoniazid; Z: pyrazinamide ; E: Ethambutol; S: Spiramicin DISCUSSION Extra pulmonary tuberculosis can be seen in one third of cases[1][2] . Cervical lymph node localization is the most common extra pulmonary localization.…”