Tuberculosis in Otorhinolaryngology: Clinical Presentation and Diagnostic Challenges

Tuberculosis affects all tissues of the body, although some more commonly than the others. Pulmonary tuberculosis is the most common type of tuberculosis accounting for approximately 80% of the tuberculosis cases. Tuberculosis of the otorhinolaryngeal region is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge. Over three years, only five out of 121 patients suspected to have tuberculosis of the otorhinolaryngeal region (cervical adenitis excluded) hadMycobacterium tuberculosisculture-proven disease. Additional 7 had histology-proven tuberculosis. Only one patient had concomitant sputum-positive pulmonary tuberculosis. We look at the various clinical and laboratory aspects of tuberculosis of the otorhinolaryngeal region that would help to diagnose this uncommon but important form of extrapulmonary tuberculosis.

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Pulmonary and testicular tuberculosis in one patient caused by Mycobacterium tuberculosis with different genotypes

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11063 ◽

2019 ◽

Vol 13 (03) ◽

pp. 261-264

Author(s):

Yuanbo Lan ◽

Ling Chen ◽

Hong Zhang

Keyword(s):

Mycobacterium Tuberculosis ◽

Unusual Case ◽

Extrapulmonary Tuberculosis ◽

Common Type ◽

Primary Site ◽

The Body ◽

Guizhou Province ◽

Common Site ◽

Pulmonary Tb ◽

And Control

Extrapulmonary tuberculosis (EPTB) accounted for 14% of 6.4 million cases of TB that were reported to WHO in 2017, and genitourinary TB (GUTB) is the second most common type of EPTB. The most common site of GUTB is the kidneys and testicular TB is relatively rare. The case of one patient with pulmonary and testicular TB caused separately by two different genotypes of Mycobacterium tuberculosis (Mtb) is further rare. Here, we present an unusual case of TB in which pulmonary TB (PTB) and testicular TB were caused by Mtb isolates with two different genotypes in a 91-year-old male patient from Zunyi, Guizhou Province of China. A better understanding of the mechanism by which a small number of tubercle bacilli are spread from the primary site of PTB to more distant parts/organs of the body, and what factors determine the potential EPTB site will provide us with new ways to prevent and control EPTB infections.

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A RARE CASE OF INFERIOR TURBINATE TUBERCULOSIS

10.36106/ijar/5300632 ◽

2020 ◽

pp. 1-2

Author(s):

R. Jaya Durgadevi ◽

Deeganta Mohanty

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Rare Case ◽

Inferior Turbinate ◽

Common Type ◽

The Body ◽

Tuberculosis Infection ◽

Mycobacterium Tuberculosis Infection ◽

Primary Tuberculosis

Tuberculosis is chronic granulomatous inammation of lung (primary tuberculosis mainly concerned with lung). Though Mycobacterium tuberculosis infection can occur in all tissues of the body, pulmonary tuberculosis infection is overwhelmingly the most common type of infection representing approximately 80% of all cases of tuberculosis 1 (TB) . Among the extrapulmonary tuberculoses, the most common 2 manifestation is lymphadenitis .

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Neurotuberculosis with intracerebral tuberculoma and PCR for detectable Mycobacterium in CSF

10.5327/1516-3180.710 ◽

2021 ◽

Author(s):

Antonio Serpa do Amaral Neto ◽

Eduarda Jaskulski ◽

Eduardo Martins Leal ◽

Matheus Marquardt ◽

Gabriel de Deus Vieira ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Clinical Presentation ◽

Epileptiform Activity ◽

Extrapulmonary Tuberculosis ◽

Clinical Signs ◽

Lower Lobe ◽

Temporal Region ◽

Diagnostic Challenge ◽

Left Frontal Lobe ◽

Meningeal Enhancement

Introduction: Neurotuberculosis is the most serious form of extrapulmonary tuberculosis. The main clinical presentation is meningoencephalitis, which may be associated with tuberculomas. The detection of Mycobacterium tuberculosis by CSF in CSF is still a diagnostic challenge. Objectives: To report a clinical case of neurotuberculosis associated with intracranial tuberculoma with detection of Mycobacterium tuberculosis by CSF in CSF. Methods: Neurotuberculosis is the most serious form of extrapulmonary tuberculosis. The main clinical presentation is meningoencephalitis, which may be associated with tuberculomas. The detection of Mycobacterium tuberculosis by CSF in CSF is still a diagnostic challenge. Results: C. A. G., 45 years old, female, admitted to the hospital in January 2020, presenting holocranial, pulsatile headache, which had worsened for 5 days, with little response to analgesics, associated with an episode of tonic-clonic seizure crisis, without other clinical signs. Previous diagnosis of asthma, using continuously salbutamol and beclomethasone. Examinations were requested - BAAR search for positive sputum, rapid molecular sputum test revealing Mycobacterium tuberculosis, clear-looking CSF, detectable CRP for Mycobacterium tuberculosis, glucose 63, protein 56.3, total cytology 74 (35% neutrophils, 19% lymphocytes , 46% macrophages). The cranial tomography showed a nodular lesion in the corticosubcortical region of the left frontal lobe, with annular enhancement by means of contrast, measuring 3.9 x 3.9 cm, in addition to accentuated meningeal enhancement. Chest tomography showed hollowed-out lesions with thickened walls, with the appearance of a sprouting tree, predominating in the lower lobe of the right lung. The diagnoses of neurotuberculosis (cerebral tuberculoma and meningitis) and pulmonary tuberculosis were then established. Referred to the infectious disease referral hospital using RHZE associated with dexamethasone and phenytoin. After 48 hours of hospitalization, the patient evolved with confusion and mental disorientation, suspecting complex subentrant partial seizures with a confused post-ictal state. A new skull tomography was requested, which showed an expansive lesion with an ovoid aspect 4.5 x 3.3 cm with liquefied content and ring impregnation by means of contrast in the upper left frontal region with mass effect and significant perilesional edema. Electroencephalogram showed disorganized base activity, periodically, sometimes with three-phase morphology, sometimes acute, in both hemispheres, with greater projection to the left and epileptiform activity also in the frontal- temporal region, bilaterally and independently. After therapeutic adjustment, the patient remained clinically stable and was discharged from the hospital with outpatient followup due to infectious diseases and neurology. Conclusion: The case addressed draws attention to the different neurological manifestations observed in neurotuberculosis, such as headache, seizures, confusion and disorientation. Early diagnosis and treatment is important to achieve a favorable outcome.

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Inguinal ulcerated sebaceous carcinoma: an unusual presentation

Anais Brasileiros de Dermatologia ◽

10.1590/abd1806-4841.20132019 ◽

2013 ◽

Vol 88 (6 suppl 1) ◽

pp. 48-51 ◽

Cited By ~ 3

Author(s):

David Oschilewski Lucares ◽

Fred Bernardes Filho ◽

Hernando Vega ◽

Bernard Kawa Kac ◽

Maria Rita Pereira ◽

...

Keyword(s):

Male Patient ◽

Clinical Manifestation ◽

Clinical Presentation ◽

Sebaceous Carcinoma ◽

The Body ◽

Skin Tumor ◽

Diagnostic Challenge ◽

Elderly Male ◽

Genital Ulcers ◽

Clinical Description

Sebaceous carcinoma is a rare and aggressive skin tumor. It can be located in any area of the body, the most commonly involved area being the periorbital region. It does not entail a typical clinical presentation, which explains the often late diagnosis. The aim of this report is to outline the rarity of the disease and its atypical clinical description, since to this day, inguinal ulcers with clinical manifestation have not been reported. We present and discuss a case of sebaceous carcinoma with an unusual clinical presentation, in an elderly male patient. The precise approach to genital ulcers, as shown in this case, is a diagnostic challenge that requires a great deal of effort on the part of the clinician.

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Gambaran pH urin pada pasien tuberkulosis paru dewasa di RSUP Prof. Dr. R. D. Kandou manado

Jurnal e-Biomedik ◽

10.35790/ebm.4.2.2016.14649 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Satrio Z. Tuah ◽

Arthur E. Mongan ◽

Mayer F. Wowor

Keyword(s):

Mycobacterium Tuberculosis ◽

Pulmonary Tuberculosis ◽

Clinical Manifestations ◽

The Body ◽

Adult Patients ◽

Acid Base Balance ◽

Urine Ph ◽

Probability Sampling ◽

Tuberculosis Patients ◽

Consecutive Sampling

Abstract: Tuberculosis (TB) is a chronic contagious infectious disease caused by Mycobacterium tuberculosis with several clinical manifestations and treatment with nephrotoxic drug regimen. This situation affects the kidney function to maintain acid-base balance of the body through urine excretion. This study aim to describe urine pH in adult tuberculosis patients in Prof. Dr. R. D. Kandou Hospital Manado. This was an observational descriptive study with samples taken by non-probability sampling, consecutive sampling types to get the urine of all tuberculosis adult patients with specified period and criteria. From 30 adult patients with pulmonary tuberculosis are inpatient and outpatient, showed the average pH of the urine in patients with pulmonary tuberculosis without comorbidities was 6.2 and in pulmonary tuberculosis patients with comorbidities was 6.4. Conclusion: The urine pH in adult pulmonary tuberculosis in RSUP. Prof. Dr. R. D. Kandou Manado with or without comorbidities are normal.Keywords: urine pH, urinalysis, tuberculosis. Abstrak: Tuberkulosis (TB) merupakan penyakit infeksi kronik menular yang disebabkan oleh Mycobacterium tuberculosis dengan beragam manifestasi klinis dan pengobatan yang menggunakan resimen obat nefrotoksik. Keadaan ini mempengaruhi ginjal dalam fungsinya untuk mempertahankan keseimbangan asam-basa tubuh melalui ekskresi urin. Penelitian ini bertujuan untuk mengetahui gambaran pH urin pada pasien tuberkulosis dewasa di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ini adalah penelitian deskriptif observasional dan sampel diambil dengan cara non-probability sampling jenis consecutive sampling untuk mendapatkan urin dari semua pasien tuberkulosis dewasa dalam kurun waktu dan kriteria yang ditentukan. Dari 30 pasien tuberkulosis paru dewasa rawat inap dan rawat jalan, menunjukkan rerata pH urin pada pasien tuberkulosis paru tanpa penyakit penyerta adalah 6,2 dan pada pasien tuberkulosis paru dengan penyakit penyerta adalah 6,4. Simpulan: Gambaran pH urin pada penyakit tuberkulosis paru dewasa di RSUP Prof. Dr. R. D. Kandou Manado dengan atau tanpa penyakit penyerta adalah normal. Kata kunci: pH urin, urinalisis, tuberkulosis

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5. Tuberculosis

Pandemics: A Very Short Introduction ◽

10.1093/actrade/9780199340071.003.0006 ◽

2016 ◽

pp. 73-88

Author(s):

Christian W. McMillen

Keyword(s):

Mycobacterium Tuberculosis ◽

Indian Ocean ◽

Pulmonary Tuberculosis ◽

The Body ◽

Bcg Vaccine ◽

Drug Resistant ◽

Modern Humans ◽

The Indian Ocean ◽

Out Of Africa ◽

Almost All

Tuberculosis, caused by Mycobacterium tuberculosis, emerged in Africa about seventy thousand years ago. It accompanied modern humans on their migrations out of Africa, across the Indian Ocean, and then into Eurasia. Tuberculosis affects almost all parts of the body. Its most common and deadly form, carried in tiny droplets through the air from person to person and highly infectious, is pulmonary tuberculosis. It thrives in densely packed places. ‘Tuberculosis’ outlines the spread of the disease, early attempts to combat it, Robert Koch’s identification of Mycobacterium tuberculosis in 1882, the development of the BCG vaccine in 1908, the use of antibiotics, and the growing multi-drug-resistant TB problem.

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Peritoneal Tuberculosis: A Forsaken Yet Misleading Diagnosis

Case Reports in Oncological Medicine ◽

10.1155/2019/5357049 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Joseph Kattan ◽

Fady Gh. Haddad ◽

Lina Menassa-Moussa ◽

Carole Kesrouani ◽

Stephanie Daccache ◽

...

Keyword(s):

Ovarian Cancer ◽

Mycobacterium Tuberculosis ◽

Ct Scan ◽

Peritoneal Carcinomatosis ◽

Respiratory Symptoms ◽

Clinical Presentation ◽

Abdominal Mass ◽

Extrapulmonary Tuberculosis ◽

Abdominal Distension ◽

Peritoneal Tuberculosis

In women presenting with an abdominal mass and ascites, the first diagnosis to consider is ovarian cancer. However, clinicians should always consider alternative differentials, namely, peritoneal tuberculosis, especially in the presence of respiratory symptoms and with the increasing prevalence of extrapulmonary tuberculosis. Peritoneal tuberculosis can mimic the clinical presentation of ovarian cancer, and on imaging, it can show similar features of peritoneal carcinomatosis and nodules. Tumor markers can also be elevated in the absence of malignancy. We present the case of a 44-year-old woman with abdominal distension and ascites. Imaging with CT scan, MRI, and PET scan were inconclusive, showing peritoneal nodules. Cytology of ascites was negative. Laparoscopy was done showing Koch bacilli followed by pulmonary sampling showing Mycobacterium tuberculosis. The patient was treated with quadritherapy with resolution of symptoms.

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A survey of tuberculosis in the industrial county of Lanarkshire, Scotland

Journal of Hygiene ◽

10.1017/s0022172400013875 ◽

1947 ◽

Vol 45 (2) ◽

pp. 232-238

Author(s):

T. Gow Brown

Keyword(s):

Family History ◽

Pulmonary Tuberculosis ◽

Tuberculous Meningitis ◽

Rural Areas ◽

Extrapulmonary Tuberculosis ◽

Human Infection ◽

Tubercle Bacillus ◽

Relative Incidence ◽

Cervical Adenitis ◽

History Of

In this investigation the hitherto unexplored field of tuberculous Lanarkshire has been surveyed.The relative incidence of human and bovine strains of the tubercle bacillus in 80 cases of pulmonary tuberculosis and in 311 cases of extrapulmonary tuberculosis has been examined. Results have shown that bovine infections were present in 2·5% of the pulmonary cases, a figure that is in keeping with the expected incidence for an area as highly industrialized as Lanarkshire.The extrapulmonary strains have been further subdivided into 165 strains isolated from patients suffering from tuberculous meningitis, 72 strains isolated from patients with cervical adenitis and 74 strains from patients with tuberculous lesions affecting bone or joint. Each group has been analysed separately.In the 165 cases of tuberculous meningitis bovine infections accounted for 28·5 % of the total. This figure was slightly higher than the 22% given by Blacklock & Griffen (1935) for the Glasgow area and the 24% of Macgregor & Green (1937) for the Edinburgh area, but it was lower than the 36% found by Munro & Scott (1936) in the east of Scotland and the 40·5% given for Scotland by Griffith (1934) in his general survey. The greater preponderance of bovine infections in rural areas supported the observations of these workers.The cervical adenitis group gave the percentage of bovine infections as 30·4, a result much lower than any previously published for Scotland, but there can be no doubt that a family history of pulmonary tuberculosis obtained from 50 % of the patients in the industrial group who supplied human strains must have been a most important factor in influencing the relative incidence of the two types of tubercle bacillus. There were 72 cases of cervical adenitis investigated and 52 came from the industrial area.Seventy-four patients suffering from tuberculous lesions affecting bone or joint gave a bovine incidence of 18·9%, a percentage that is lower than that given by Munro & Cumming (1926) of 36·4% but approximating to the 20·5% given by Wang (1917) for the Edinburgh area. Munro & Cumming were dealing with a less industrialized area than Lanarkshire which probably accounts for the variation as also does the fact that, of 7 human cases occurring in the rural part of Lanarkshire, 5 gave a family history of pulmonary tuberculosis.These figures only serve to substantiate observations of regional variation and endorse the findings of other workers who have found a lower proportion of bovine infections in industrial districts. As Lanarkshire is the most highly industrialized county in Scotland it was to be expected that the results of this investigation might have given an even greater predominance of human infection than actually was found.

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Laryngeal tuberculosis in the eighties—an Indian experience

The Journal of Laryngology & Otology ◽

10.1017/s0022215100110321 ◽

1989 ◽

Vol 103 (9) ◽

pp. 864-868 ◽

Cited By ~ 22

Author(s):

V. Rupa ◽

T.S. Bhanu

Keyword(s):

Diabetes Mellitus ◽

Pulmonary Tuberculosis ◽

Clinical Presentation ◽

Extrapulmonary Tuberculosis ◽

Miliary Tuberculosis ◽

X Rays ◽

Laryngeal Oedema ◽

Indian Experience ◽

Age Range ◽

Laryngeal Tuberculosis

AbstractLaryngeal tuberculosis is one of the rarer forms of extrapulmonary tuberculosis. A retrospective analysis of 26 patients seen in the last nine years in our hospital was conducted to illustrate the various modes of clinical presentation. Of the 26 patients, twenty were male and six female. The average age of presentation was 47 years with an age range of 15 months to 71 years. Hoarseness (92.3 per cent) was the commonest symptom. The laryngoscopic appearances often simulated malignancy. Most patients (69.2 per cent) outnumbered ulcerative ones (38.5 per cent). Laryngeal oedema was infrequent (7.7 per cent). Diagnosis was based on a laryngeal biopsy in 18 patients and on evidence of associated pulmonary tuberculosis and response to anti-tuberculous therapy in eight. Chest X-rays showed apical cavitation and infiltration as the commonest findings. Three patients had miliary tuberculosis and one had no pulmonary lesion. Diabetes mellitus was present in seven (26.9 per cent) patients. Four illustrative cases are described. The problems in diagnosis and management of laryngeal tuberculosis are discussed.

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Thoracic Extrapulmonary Tuberculosis in the Millennial Era

Update in Respiratory Diseases ◽

10.5772/intechopen.90376 ◽

2020 ◽

Author(s):

Onix J. Cantres-Fonseca

Keyword(s):

Mycobacterium Tuberculosis ◽

Clinical Manifestation ◽

Extrapulmonary Tuberculosis ◽

Clinical Manifestations ◽

Lung Infection ◽

The Body ◽

Morbidity And Mortality ◽

General Treatment ◽

Pulmonary Parenchyma ◽

Infectious Organism

Mycobacterium tuberculosis is one of the most pathogenic infectious organisms, usually known for causing cavitary lung infection. But this mycobacterium is also capable of causing masked involvement in any organ of the body. Its clinical manifestation can mimic other conditions according to the organ affected. Extrapulmonary infection is defined as any manifestation caused by tuberculosis in tissues outside the airway or the pulmonary parenchyma. Despite it being a well-known infectious organism throughout decades, tuberculosis continues to be causing great morbidity and mortality in this millennium. This chapter will discuss the clinical manifestations of extrapulmonary tuberculosis (EPTB), when the mycobacteria invade extrapulmonary tissues inside the thorax. We discuss and review the literature about the clinical manifestations, diagnosis and evaluation, and general treatment.

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