Isolated laryngeal tuberculosis: A diagnostic dilemma

Abstract

Introduction and importance: Primary laryngeal tuberculosis (PLTB) is a rare condition. The symptoms and findings are not specific in most of the cases. Patients are diagnosed essentially based on histopathological examination and mycobacterial culture.

Case report: We report the case of a 42-year-old woman who presented to our hospital with dysphonia and dysphagia. Direct laryngoscopy revealed a lesion of the supraglottis. CT scan found a diffuse thickening of the entire surface of the larynx. A biopsy confirmed the diagnosis of tuberculosis.

Clinical discussion: Primary laryngeal tuberculosis is a rare clinical entity despite its close anatomical and physiological proximity to the lungs.

Conclusion: Clinician should keep in mind the existence of primary laryngeal tuberculosis to avoid delayed diagnosis and treatment, which can lead to high morbidity and mortality.

Keywords: Anti tubercular drugs; Case report; Larynx; Primary; Tuberculosis.

Fig. 1

a,b. Direct laryngoscopy showing diffuse congestion and irregular lesions on the supra-glottic region (epiglottis and false vocal cords), arytenoids, interarytenoid region and aryepiglottic folds. c. Vocal cords were moving with no signs of infiltration. Fig. 1A′. Laryngeal CT scan revealed a diffuse thickening and homogeneous contrast enhancement of the entire surface of the larynx with intact cartilaginous framework; B. Sagittal image showed irregular thickening of the epiglottic from where the biopsy was taken (arrow).