Huge Atypical Sub Mental Swelling: A Rare Presentation of Tuberculosis of Neck
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CLINICAL REPORT
Huge Atypical Sub Mental Swelling: A Rare Presentation of Tuberculosis of Neck Sambhaji G. Chintale1,2
•
Vilas R. Kirdak1 • Sonali P. Jatale1 • Kaleem A. Shaikh1
Received: 20 July 2020 / Accepted: 17 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract As we know tuberculosis is common disease in developing country since historical days. But now a days cases of HIV increases in all over country since last 2 decades. Incidence of tuberculosis also increased despite of treatment coverage for tuberculosis through nationwide antibuberculosis program in our developing country. We reported one case of huge sub mental swelling in 55 years old male patient having symptoms of swelling since 2 years and difficulty in breathing since 1 month. This on FNAC gives nonspecific lymphadenitis later confirmed on excisional biopsy comes out to be tuberculosis. Keywords Cervical lymph node Submental Tuberculosis
Introduction Tuberculosis is worldwide infectious disease; pulmonary disease is common in developed and developing country. Though the pulmonary tuberculosis cases are more in our country the extrapulmonary cases are also increased due to human immunodeficiency virus [1]. Low socio economic class, living in crowded places, nutritional deficiency all this conditions are also responsible for rising case of tuberculosis in our country. Extra pulmonary sites include
& Sambhaji G. Chintale [email protected] 1
Department of Otorhinolaryngology, JIIUS IIMSR, Warudi, Tq Badnapur Dist., Jalna 431202, India
2
Cosmo ENT Superspeciality Hospital and Research Center Aurangabad, Kamgar Chauk, Cidco n3, Aurangabad 431005, India
cervical neck, larynx, ear, spine, brain, skin, gastrointestinal system. Out of all this sites tuberculosis of the head and neck region comprises about 10% of all the cases of extrapulmonary tuberculosis and cervical lymph nodes are the most commonly affected followed by laryngeal tuberculosis, deep neck space abscess and tuberculosis otitis media [2, 3].
Case Report A 55 years old male patient present with complaint of swelling since 2 years initially the swelling was very small and gradually this swelling increased causing difficulty in breathing to the patient for which he visited to our ENT department OPD. On detail history there was no past history of similar complaint, no history of fever, cough, no history of diabetes mellitus, no history of hypertension and no any history of contact to the tuberculous patient. On clinical examination of patient neck there was huge neck swelling approx. 10 cm 9 8 cm as shown in Fig. 1. No other any swelling in posterior triangle of neck.On detail examination of oral cavity there was no dental caries and no sublingual oral swelling as shown in Fig. 2. Through clinical palpable examination of other part of body done like abdomen, axillary, inguinal area for any lymph node enlargement. On auscultation respiratory and cardiovascular system was normal. Then we done the through blood investigation like CBC, ESR, KFT, serum electrol
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