Publication:

Otorhinolaryngological manifestations of tuberculosis

Background Tuberculosis (TB) of head and neck is a rare form of extrapulmonary TB but still poses a significant clinical and diagnostic challenge. Rare occurrence and unspecific symptoms of extrapulmonary tuberculosis often leads to misdiagnosis. The aim of the study was to evaluate the various otolaryngological manifestations of extrapulmonary TB and make otolaryngologist aware of these manifestations.

Methods This prospective study included 40 cases who presented to us at a tertiary hospital with various symptoms of head and neck TB. Detailed history with ear, nose throat examination was carried out on all patients. Fine needle aspiration cytology (FNAC), histopathology and Acid-fast bacilli (AFB) staining were done to confirm the diagnosis. After confirmation, patients were started on anti-TB therapy and showed good response to the treatment.

Results The study included 40 cases who presented to us at a tertiary hospital with various symptoms of head and neck tuberculosis. The majority of these cases had cervical lymphadenopathy (55%) followed by deep neck abscess (20%), laryngeal TB (15%), tubercular otitis media (7.5%) and nasal TB (2.5%). Majority of the cases (65%) belonged to lower socio-economic status. 42.5% of cases had family history of pulmonary TB. Six out of 40 subjects had co-existing pulmonary TB.

Conclusions Otorhinolaryngeal TB can involve any site with unspecific symptoms. The most commonly site involved is cervical lymph node presenting as neck swelling. Variable nature of its manifestations makes it necessary to have high degree of clinical suspicion to make early diagnosis.