原発性扁桃結核例

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  • A Case of Primary Tonsillar Tuberculosis
  • 臨床 原発性扁桃結核例
  • リンショウ ゲンパツセイ ヘントウ ケッカクレイ

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<p>In recent years, the prevalence of tuberculosis has decreased due to the development of antituberculosis drugs and promotion of tuberculosis control, and opportunities to diagnose and treat tuberculosis are rare.</p><p>Herein, we report the case of a 37-year-old female patient with tuberculosis of the tonsil, in whom multiple tests were required before the diagnosis could be established. She gave a history of having had an enlarged left tonsil from the age of 12 years. She visited an otorhinolaryngology clinic with enlarged left cervical lymph nodes, which she had first noticed 3 weeks earlier, and was referred to our department for further examination and treatment.</p><p>Histopathological examination of the tonsil showed granulomatous tonsillitis caused by acid-fast bacteria, although it was difficult to identify the species. While Mycobacterium tuberculosis could not be identified by smear tests and polymerase chain reaction assay of the tonsil, it was isolated by culture. Chest imaging did not reveal any abnormal opacities in the lung fields, and sputum culture was negative for Mycobacterium tuberculosis. Primary tonsillar tuberculosis was suspected, and the patient was treated with oral anti-tuberculosis drugs for 6 months. While her left tonsil shrank slightly, we suspected that the disease was still not well controlled. Therefore, we performed left tonsillectomy for the purpose of assessing the therapeutic effect after 4 months of treatment with antituberculosis drugs.</p><p>Histopathological examination of the resected tonsil showed no tuberculosis lesions. Smear and culture tests, as well as polymerase chain reaction assay were negative. We considered that the tuberculosis had been cured by the antituberculosis drug therapy. She has shown no signs of recurrence so far.</p><p>In cases of suspected tuberculosis, multiple tests may be needed to establish the diagnosis.</p>

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