Coimbra AC1* , Santos da Cruz SF1 , Martinolli TSR1 , Vaczy C2 and Brito CVB3
1 Department of Medicine, State University of Para (UEPA), Brazil 2 University of Rochester Medical Center, USA 3 Department of Surgery, State University of Para (UEPA), BrazilFulltext PDF
Laryngeal Tuberculosis (LT) is a rare disease that represents less than 2% of cases of extrapulmonary tuberculosis and is the most frequent granulomatous disease in the larynx. The diagnosis is possible from the histopathological and microbiological analysis of laryngeal lesion fragments obtained by biopsy. However, the recognition is often difficult due to the varied clinical symptoms, often, limited to dysphonia and odynophagia, while typical tuberculosis symptoms such as fever, cough and night sweats are absent. The purpose of the present study is to report a case of laryngeal tuberculosis in order to reduce under diagnosis rates and inappropriate treatment. In this study, a 39 year-old female presented at first only dysphagia and dry cough, no history of fever or weight loss, sputum culture negative for Mycobacterium tuberculosis and chest X-ray without signs of pulmonary involvement. However, patient underwent otorhinolaryngological evaluation through laryngoscopy, which revealed destructive, vegetative, infiltrative growth involving epiglottis, arytenoids, vestibular folds and bilateral aryepiglottic folds on the larynx; however, only received anti-inflammatory treatment, which did not relieve symptoms. After 6 months, the patient complained of fever, dysphagia, sialorrhea, and gagging, productive cough, dysphonia and weight loss of 26 pounds. One month later, histopathology of laryngeal biopsy revealed chronic granulomatous inflammation, suggesting tuberculosis. Thus, the patient was immediately started on the standard four-drug anti tuberculosis (anti-TB), evidencing on the follow-up symptomatically improvement with treatment. Even though laryngeal tuberculosis is a rare disease, every otorhinolaryngologist should be aware of its clinical characteristics to be able to suspect and conduct the case correctly.
Extrapulmonary tuberculosis; Laryngeal tuberculosis; Mycobacterium tuberculosis; Dysphagia
Coimbra AC, Santos da Cruz SF, Martinolli TSR, Vaczy C, Brito CVB. Laryngeal Tuberculosis Study. Ann Clin Otolaryngol. 2019; 4(1): 1038.