A case of nasopharyngeal tuberculosis

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  • Ohira Noriko
    Department of Otolaryngology, Kindai University Faculty of Medicine
  • Mori Anjin
    NTT Medical Center Tokyo
  • Otsuki Naoki
    Department of Otolaryngology, Kindai University Faculty of Medicine
  • Doi Katsumi
    Department of Otolaryngology, Kindai University Faculty of Medicine

Bibliographic Information

Other Title
  • 上咽頭病変を契機に発見された結核症例
  • ジョウ イントウ ビョウヘン オ ケイキ ニ ハッケン サレタ ケッカク ショウレイ

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Description

Nasopharyngeal tuberculosis is a rare type of extrapulmonary tuberculosis that accounts for approximately 0.2% of all tuberculosis cases worldwide. We herein report a case of nasopharyngeal tuberculosis in a patient who presented with a cough and sore throat. Nasopharyngeal endoscopy revealed a mucosal lesion with a white coating in the left fossa of Rosenmüller. The patient was diagnosed with nasopharyngeal tuberculosis based on positive results from staining for acid-fast bacilli in the pharyngeal mucosa, and on a polymerase chain reaction （PCR） assay for Mycobacterium in sputum. Chest radiography revealed pulmonary tuberculosis; thus, multiple anti-tuberculosis drug therapy was initiated. The nasopharyngeal mucosal lesion was no longer observed on nasopharyngeal endoscopy after 6 weeks of multi-drug therapy. <br>The symptoms of nasopharyngeal tuberculosis vary and can include cough, cervical lymphadenopathy, otorrhea, sore throat, nasal congestion, weight loss, and fever. Two main types of manifestations of this form of tuberculosis observed on nasopharyngeal endoscopy are mass lesions and ulcerative lesions, which mimic nasopharyngeal malignancies. Diagnosing nasopharyngeal tuberculosis definitively can be difficult because of the lack of specific findings and symptoms, and several examination modalities are usually needed to confirm the initial diagnosis. Nasopharyngeal tuberculosis should be considered as a differential diagnosis of mucosal lesions with a white coating in the nasopharynx. As the sensitivity of microbiological culture is relatively low, repeated pathological examinations and PCR assays are essential for early and appropriate diagnosis. In conjunction with this difficulty in diagnosing nasopharyngeal tuberculosis, special attention must be paid to protect healthcare workers from occupational exposure. Rapid identification of staff with potential infection and application of routine screening tests are key to preventing secondary infections.

Journal

  • Stomato-pharyngology

    Stomato-pharyngology 35 (1), 25-29, 2022

    Japan Society of Stomato-pharyngology

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