Isolated Laryngeal Tuberculosis: a Diagnostic Dilemma
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CLINICAL REPORT
Isolated Laryngeal Tuberculosis: a Diagnostic Dilemma Harsha Pandiyan1 • Nikhil Sivanand2
•
S. Sathish Kumar1
Received: 9 July 2020 / Accepted: 2 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract Laryngeal tuberculosis is a rare condition, isolated laryngeal tuberculosis without pulmonary manifestations is even more rare. Patients usually presents with voice change, difficulty in swallowing and other constitutional symptoms. The symptoms and findings can look like malignancy in most of the cases. Here, we present a case of primary laryngeal tuberculosis without pulmonary tuberculosis. A 24 year old man who presented to us with hoarseness of voice with 1 year duration. Laryngoscopic study showed a proliferative growth in the epiglottis, aryepiglottic folds and vocal cords and was diagnosed to have laryngeal tuberculosis on histopathology by the typical appearance of granuloma and caseous necrosis. The patient was started on standard antitubercular therapy and he had an excellent response to the same within 6 months. Isolated laryngeal tuberculosis should be suspected in patients with laryngeal complaints with no pulmonary symptoms, especially in a developing country like India where pulmonary tuberculosis is prevalent. Even though isolated laryngeal tuberculosis cases are rare, we should keep in mind the possibility of tuberculosis in the differential diagnosis of laryngeal tumors, as the incidence of tuberculosis is steadily increasing.
Keywords Tuberculosis Primary Larynx Anti tubercular drugs
Introduction The incidence of pulmonary tuberculosis in India has decreased drastically due to advancements in Public Healthcare and standardization in treatment protocols by national programmes for the same. Extra pulmonary tuberculosis is usually secondary to pulmonary tuberculosis in the bygone era but according to the recent literature review, isolated extra pulmonary tuberculosis alone can be seen due to an increase in life expectancy and by a decline in BCG vaccination. Laryngeal tuberculosis can develop either due to direct spread of mycobacterium tuberculosis to the larynx from the contaminated sputum or by hematogenous spread. The clinical findings can mimic laryngeal carcinoma and has to be diagnosed correctly. The incidence of laryngeal tuberculosis was about 33% in the pre antibiotic era, but with the advent of antitubercular drugs, the incidence has come down to less than 1%. In this study, we present a case of primary laryngeal tuberculosis.
Case Presentation & Nikhil Sivanand [email protected] 1
Department of ENT, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India
2
Department of ENT, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry, India
A 24 year-old male patient, shop keeper by occupation presented with 1 year history of change in voice to the outpatient department of Otorhinolaryngology at Vydehi Institute of Medical Sciences and Research
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