scholarly journals Laryngeal Tuberculosis: an uncommon but important cause of odynophagia

2017 ◽  
Vol 4 (6) ◽  
pp. 1699
Author(s):  
Abhishek Agarwal ◽  
Asna Khan ◽  
Saurav Pandey ◽  
Arvind Kumar Vaish

Tuberculosis can occur as pulmonary tuberculosis or as extrapulmonary tuberculosis. The commonest forms of extrapulmonary tuberculosis include the pleural tuberculosis and the lymph node tuberculosis. Here we are describing an interesting case of laryngeal tuberculosis which presented to us with odynophagia. The diagnosis was suspected on basis of chest x-ray and CT thorax, but it could only be confirmed after direct visualization of the larynx on fibreoptic bronchoscopy and by taking biopsy from the epiglottis under direct visualization.

1976 ◽  
Vol 85 (4) ◽  
pp. 547-548 ◽  
Author(s):  
Sirus Naraqi ◽  
Manfred W. Raiser ◽  
N. Mark Richards ◽  
Burton R. Andersen

A patient with laryngeal and pulmonary tuberculosis is described. The similarity between the clinical presentation and gross appearance of laryngeal carcinoma and tuberculosis in this patient and others reported in the literature is emphasized. Laryngeal biopsy is necessary to establish the correct diagnosis, but this must be done only after the proper precautions are taken to reduce the risk of infection to the physician performing the biopsy. Examination of the chest x-ray and acid-fast stain of the sputum are rapid and highly reliable screening tests for laryngeal tuberculosis.


1981 ◽  
Vol 95 (4) ◽  
pp. 393-398 ◽  
Author(s):  
A. M. Hunter ◽  
J. W. Millar ◽  
A. J. A. Wightman ◽  
N. W Horne

SummaryLaryngeal tuberculosis is now an uncommon disease in the United Kingdom. A series of ten cases is reported. In contrast to the pre-chemotherapy era, when the disease was associated with advanced cavitated pulmonary tuberculosis and was highly infectious, it now presents in a manner similar to laryngeal carcinoma except that painful dysphagia is a prominent symptom. All such patients should have a chest X-ray carried out as part of their initial investigation. Sputum is almost always positive for tubercle bacilli on direct films. Direct laryngoscopy and biopsy are necessary if a carcinoma is suspected.The change of pattern of the disease may be due to the fact that the larynx now usually becomes involved by haematogenous spread rather than by direct spread along the airways. Laryngeal tuberculosis is now no more infectious than pulmonary tuberculosis, and responds well to antituberculous chemotherapy. Symptoms resolve completely within three weeks if corticosteroids are given in combination.


Author(s):  
Richard Wismayer

Introduction: Tuberculosis remains a global public health concern. Abdominal tuberculosis is an atypical presentation and since it is extrapulmonary it may delay the diagnosis and treatment of this condition. The case report describes a typical presentation of abdominal tuberculosis and highlights the difficulties which are encountered in the diagnosis of abdominal tuberculosis. Presentation of case: A 56 year old gentleman admitted to hospital with a 1 week history of generalised abdominal pain associated with abdominal distention and vomiting. The chest-X-ray was unremarkable and the abdominal X-ray revealed air-fluid levels. Laboratory investigations revealed a high white cell count at 14,000µl. At laparotomy, multiple small whitish deposits in the greater omentum and on the bowel with a frozen abdomen was found. Biopsy of these whitish deposits showed histology of giant Langhans multinucleated cells with acid-fast bacilli and necrosis and a granulomatous inflammatory process. Anti-tuberculosis treatment was initiated using a combination of antibiotics and he made an uneventful recovery. Discussion: The clinical abdominal TB presentations include acute, subacute or chronic disease. The chest-X-ray of our patient showed no evidence of pulmonary tuberculosis however this is not surprising as less than half of patients with abdominal TB have pulmonary tuberculosis. Ultrasound findings in abdominal TB include thickening of the wall of the ileum, caecum and colon and associated ascites. When malignancy cannot be ruled out with certainty then laparotomy is recommended with biopsy of any peritoneal lesions, omental lesions and a lymph node biopsy. Conclusions: Judicious use of diagnostic procedures and a high index of suspicion may help in the timely diagnosis and treatment of abdominal tuberculosis. Biopsy of peritoneal/omental lesions and of a mesneteric lymph node is advisable to distinguish abdominal tuberculosis from peritoneal carcinomatosis.


Praxis ◽  
2019 ◽  
Vol 108 (15) ◽  
pp. 991-996
Author(s):  
Ngisi Masawa ◽  
Farida Bani ◽  
Robert Ndege

Abstract. Tuberculosis (TB) remains among the top 10 infectious diseases with highest mortality globally since the 1990s despite effective chemotherapy. Among 10 million patients that fell ill with tuberculosis in the year 2017, 36 % were undiagnosed or detected and not reported; the number goes as high as 55 % in Tanzania, showing that the diagnosis of TB is a big challenge in the developing countries. There have been great advancements in TB diagnostics with introduction of the molecular tests such as Xpert MTB/RIF, loop-mediated isothermal amplification, lipoarabinomannan urine strip test, and molecular line-probe assays. However, most of the hospitals in Tanzania still rely on the TB score chart in children, the WHO screening questions in adults, acid-fast bacilli and chest x-ray for the diagnosis of TB. Xpert MTB/RIF has been rolled-out but remains a challenge in settings where the samples for testing must be transported over many kilometers. Imaging by sonography – nowadays widely available even in rural settings of Tanzania – has been shown to be a useful tool in the diagnosis of extrapulmonary tuberculosis. Despite all the efforts and new diagnostics, 30–50 % of patients in high-burden TB countries are still empirically treated for tuberculosis. More efforts need to be placed if we are to reduce the death toll by 90 % until 2030.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S810-S810
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Fatma Smaoui ◽  
...  

Abstract Background Lymph node tuberculosis (LNTB) represents the most common site of extrapulmonary tuberculosis. Among children, due to non-specific clinical features, the diagnosis is often delayed. We aimed to compare the clinical, therapeutic and evolutionary features of LNTB between adults and children. Methods We conducted a retrospective study including patients hospitalized for LNTB in the infectious diseases and pediatric department between 1993 and 2018. Children aged ≤18 years were included. Results Overall, we encountered 231 cases of LNTB. There were 40 children (17.3%) with a mean age of 11±4 years and 191 adults (82.7%) with a mean age of 42±16 years. As to gender, females were more affected (adults: 67% vs children: 70%), with no significant difference (p >0.05). A family history of tuberculosis was significantly more frequent among children (20% vs 6.3%; p=0.01). Raw milk consumption (38.2% vs 30%; p >0.05) and close contact with animals (29.8% vs 35%; p >0.05) were noted among both adults and children. Fever (53.4% vs 32.5%; p=0.01), night sweats (35.8% vs 10%; p=0.001), loss of appetite (38.2% vs 17.5%; p=0.01) and weight loss (35.1% vs 15%; p=0.01) were significantly more frequent among adults. Tuberculin skin test was positive in 75.8% of the cases among adults and in 86.2% of the cases among children (p >0.05). Multifocal tuberculosis was significantly more frequent among adults (23.8% vs 5.7%; p=0.01). Antitubercular therapy was prescribed for a mean duration of 10±4 months among adults and for 9±3 months among children, with no significant difference (p >0.05). Side effects of antitubercular drugs were more frequent among adults (33% vs 10.3%), with a significant difference (p=0.004). Comparison of the disease evolution showed no significant difference between adults and children, regarding recovery (94.8% vs 90%), relapse (5.2% vs 5%) and death (0.5% vs 2.5%). Conclusion The clinical presentation of LNTB among children was less common and misleading. A family history of tuberculosis and a high index of suspicion might shorten the diagnostic delay. Disclosures All Authors: No reported disclosures


Thorax ◽  
2010 ◽  
Vol 65 (10) ◽  
pp. 863-869 ◽  
Author(s):  
A. P. Ralph ◽  
M. Ardian ◽  
A. Wiguna ◽  
G. P. Maguire ◽  
N. G. Becker ◽  
...  

2021 ◽  
pp. 10-12
Author(s):  
Abdhesh Kumar ◽  
Naveen Kumar ◽  
Kumar Sourav

Background: Fight against human immunodeciency virus (HIV) is incomplete without addressing problems associated with difcult diagnosis of tuberculosis in HIV-Tuberculosis coinfected patients. Chest X-ray is a primary tool to evaluate tuberculosis in HIV. Aim: To assess and compare various radiological patterns of pulmonary tuberculosis in HIV patients and compare these patterns in relation to CD4 counts. Materials and Methods: Prospective cohort study was conducted in a tertiary hospital in J.L.N.M.C.H Bhagalpur from april 2019 to january 2021 with 200 HIV positive patients. WHO guidelines were used for diagnosis of HIV and tuberculosis. Results: 27% of the patients had sputum positive pulmonary tuberculosis, with higher incidence (33%) among CD4 less than 200 as compared to CD4 more than 200 (14%). Inltration (39%) followed by consolidation (30%), cavity (11%), and lymphadenopathy (9%) seen with CD4 less than 200. Inltration (37.5%) followed by cavity (25%) and miliary (25%) with CD4 above 200. Bilateral (68.5%) and mid and lower zones or all zone involvement more commonly seen. Conclusion: In patients with CD4 lower than 200 noncavitory inltration and consolidation predominated. Involvement of lungs was atypical; diffuse or mid and lower zone involvement was higher than classical upper lobe involvement. A high index of suspicion is necessary for the accurate and timely diagnosis of tuberculosis in HIVpositive patients.


Thorax ◽  
2014 ◽  
Vol 69 (Suppl 2) ◽  
pp. A43-A43
Author(s):  
S. Murthy ◽  
F. Chatterjee ◽  
P. Phillips ◽  
S. Murray ◽  
T. McHugh ◽  
...  

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.


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