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. 2022 Dec;74(Suppl 3):5562-5568.
doi: 10.1007/s12070-021-02903-3. Epub 2021 Oct 8.

Extrapulmonary Tuberculosis: An Otorhinolaryngologist's Perspective

Nittu Thomas  1 , Sapna Sreedharan Nambiar  1 , P Muraleedharan Nampoothiri  1
Affiliations

Extrapulmonary Tuberculosis: An Otorhinolaryngologist's Perspective

Nittu Thomas et al. Indian J Otolaryngol Head Neck Surg. 2022 Dec.

Abstract

Objective: The study aimed to determine the clinical manifestations and epidemiology of extrapulmonary tuberculosis (EPTB) of the head and neck in the otorhinolaryngeal regions. There is an increase in the incidence of EPTB in recent years because of increase in immunocompromised states and development of resistant bacteria. The clinical symptoms and signs of EPTB of the otorhinolaryngeal regions overlap with that of malignancies and other diseases in otorhinolaryngology thereby requiring correct early diagnosis so as to avoid unnecessary surgeries and procedures with initiation of appropriate anti tuberculous treatment under RNTCP.

Study design: Our prospective study was done on 45 patients who attended the ENT OPD at a tertiary care centre in Southern India over a period of 18 months with diagnosed EPTB of the otorhinolaryngeal regions.

Results: The study included 29 (64.4%) patients who presented with cervical lymphadenopathy, 11 (24.4%) patients with tuberculous laryngitis, 3 (6.6%) patients with tuberculous otitis media and 1 each with nasal and oral cavity tuberculosis. In our study 6 (13.3%) patients had co-existing pulmonary tuberculosis, 8 (18%) had diabetes, 5 (11%) had past history of tuberculosis and 7 (16%) had contact with patient with tuberculosis.

Conclusion: A high index of suspicion of EPTB must be kept among patients where (i) the clinical symptoms are out of proportion to the signs, (ii) common treatment fails or (iii) there is persistence or recurrence of symptoms despite therapy. The challenge is in confirming diagnosis which requires histopathological examination (HPE) of the tissue specimen. The timely diagnosis and initiation of anti tuberculous treatment (ATT) as per RNTCP helps in complete recovery thereby reducing morbidity.

Keywords: Anti tuberculous treatment (ATT); Extrapulmonary tuberculosis (EPTB); Tuberculous laryngitis; Tuberculous lymphadenopathy; Tuberculous otitis media.

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Figures

Fig. 1
Fig. 1
Cervical lymphadenopathy with involvement of the lymph nodes in posterior triangle of neck
Fig. 2
Fig. 2
Videolaryngoscopy in a patient with tuberculous laryngitis showing Rt Vocal cord involvement affecting the posterior 2/3rd mainly
Fig. 3
Fig. 3
Nasal Tuberculosis—patient presented with ulcer over the left side of the columella
See this image and copyright information in PMC

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References

    1. World Health Organisation (2016) WHO/HTM/2016.13.Geneva: World Health Organisation. Global tuberculosis report 2016
    1. World Health Organisation . Tuberculosis programme: framework for effective tuberculosis control. Geneva: WHO; 1994.
    1. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120:316–353. - PubMed
    1. Prakasha SR, Suresh G, D’sa IP, Shetty SS, et al. Mapping the pattern and trends of extrapulmonary tuberculosis. J Glob Infect Dis. 2013;5(2):54–59. doi: 10.4103/0974-777X.112277. - DOI - PMC - PubMed
    1. Kulchavenya E. Extrapulmonary tuberculosis: Are statistical reports accurate? Ther Adv Infect Dis. 2014;2(2):61–70. - PMC - PubMed

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