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Case Reports
. 2020 Jun 5;15(1):508-512.
doi: 10.1515/med-2020-0171. eCollection 2020.

Mycobacterial identification on homogenised biopsy facilitates the early diagnosis and treatment of laryngeal tuberculosis

Zhenjun Yu  1 , Ruyue Lu  2 , Meifu Gan  3 , Xi Tu  2 , Zebao He  1
Affiliations
Case Reports

Mycobacterial identification on homogenised biopsy facilitates the early diagnosis and treatment of laryngeal tuberculosis

Zhenjun Yu et al. Open Med (Wars). .

Abstract

Introduction: The incidence of laryngeal tuberculosis has increased gradually in recent years. Laryngeal tuberculosis has strong infectivity and atypical clinical manifestations. Hence, establishing the early diagnosis of laryngeal tuberculosis is considered difficult, resulting in the high rate of misdiagnosis of laryngeal tuberculosis and increased rates of tuberculosis infection.

Objective: This study aimed to describe a case of laryngeal tuberculosis detected using the mycobacteria gene chips technology, facilitating the early diagnosis and the treatment of laryngeal tuberculosis.

Case presentation: A 27-year-old woman presented with a 7-day history of hoarseness, with a normal routine blood chemistry test and chest computed tomography results. Histological analysis of the vocal cord biopsy showed granulomatous inflammation and the negative acid-fast stain test. The mycobacteria gene chips method was used to directly examine the vocal cord tissue treated with homogenate, and the Mycobacterium tuberculosis was successfully identified. Thus, the early diagnosis of laryngeal tuberculosis and the drug sensitivity of rifampin and isoniazid were confirmed. The patient recovered after undergoing a 1-year standard anti-tuberculosis therapy.

Conclusions: Mycobacterial identification on homogenised biopsy using the mycobacteria gene chips method significantly facilitates the early diagnosis and the treatment of tuberculosis.

Keywords: gene chips; laryngeal tuberculosis; mycobacterial identification.

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Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
(a) Laryngoscopy revealed laryngeal mucosa hyperaemia and milky hyperplastic lesion in the bilateral vocal cords. (b) Laryngoscopy revealed the laryngeal mucosa without hyperaemia, and the hyperplastic lesion in the vocal cords completely disappeared after the patient underwent a 1-year standard anti-tuberculosis therapy.
Figure 2
Figure 2
(a) Original magnification ×200. Histological analysis of the biopsy specimen from the vocal cords revealed granulomas with inflammatory cell infiltration in the squamous epithelium and interstitial tissue. (b) The result of the acid-fast stain for vocal cord biopsy was negative.
Figure 3
Figure 3
(a) Identification of bacteria by mycobacteria gene chips showed Mycobacterium tuberculosis. (b) Identification of rifampin-resistant gene detected by mycobacteria gene chips showed that 511WT, 513WT, 516WT, 526WT, 531WT, and 533WT were all wild type. (c) Identification of isoniazid-resistant gene detected by mycobacteria gene chips showed that katG315 and inhA-15 were wild types.
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