Manifestations of Tuberculosis in Ear, Nose, Throat, Head and Neck Region – A Retrospective Study
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Abstract
Introduction
Tuberculosis can involve any organ or site. Otorhinolaryngologist may encounter tuberculosis affecting lymph nodes, ear, larynx, deep neck spaces, salivary glands etc. which can mimic other chronic granulomatous conditions or malignancy. To ensure early diagnosis, it is important to recognize its cardinal signs and symptoms and to be aware of potential pitfalls in diagnosis. This study was done to learn the clinical presentation of tuberculosis in ear, nose, throat and head and neck region, and to assess the effectiveness of various investigations and treatment done for the same.
Materials and Methods
A retrospective study done in our institution involving 120 patients suffering from tuberculosis in ear, nose, throat and head and neck region who attended pulmonary medicine or ENT OPD or ward between January 2008 to December 2017 that is, 10 years. Study period for data collection and analysis was 1 month.
Results
Total 120 patients-69 males and 51 females. Most common site was cervical lymph nodes(77.5% patients), followed by larynx(8.3%),middle ear(7.5%),deep neck spaces(2.5%) and salivary glands and nose(1.7% each). Histopathology was highly sensitive(99. 1%).All except one patient responded to first-line antitubercular drugs, the other patient was given treatment for MDR-TB to which he responded.
Conclusion
Tuberculosis can involve any site in the head and neck region, most common being cervical lymph nodes mainly presenting as neck swelling. Variable nature of manifestations of tuberculosis makes it essential to have high degree of suspicion for early diagnosis.
Article Details
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References
Global tuberculosis report 2015 [Internet]. Geneva World Health Organization 2015. Available at: http://www.who.int/ tb/publications/ global_report/en/. Accessed Mar 01, 2016
Aisenberg GM,Jacobson K,Chemaly RF, Rolston KV, Raad II, Safdar A. Extrapulmonary tuberculosis active infection misdiagnosed as cancer:mycobacterium tuberculosis disease in patients at a Comprehensive cancer centre(2001-2005). Cancer 2005;104(12):2882-87
Khan KA, Khan NA, Maqbool IM. Otorhinolaryngological manifestations of tuberculosis. JK Sci. 2002; 4(3):115-8
Two hour detection of MTB and resistance to rifampicin. Cepheid International 2011. https://www.cepheid.com/en. Accessed Jul 2018
RNTCP national strategic plan 2017-2025. NSP draft 2017-2025
Sharma S, Sarin R, Khalid U.K, Singla N, Sharma PP, Behera D. Clinical profle and treatment outcome of tuberculous lymphadenitis in children using DOTS strategy. Indian J Tuberc. 2010; 57:4-11
Baskota DK, Prasad R, Sinha BK, Amatya RC. Distribution of lymph nodes in the neck in patients of tuberculous cervical lymphadenitis. Acta Otolaryngologica 2004;124(9):1095-98
Jha BC, Das A, Nagarkar NM, Gupta R, Singhal S. Cervical tuberculous lymphadenopathy:
changing clinical pattern and concepts in management. Postgrad Med J. 2001; 77:185-7
Nalini B, Vinayak S. Tuberculosis in ear,nose,and throat practices :its presentation and diagnosis. Am J Otolaryngol. 2006; 27(1):39-45.doi:10.1016/j.amjoto.2005.07.005
Malakar D, Jajoo I, Swarup K, Gupta OP, Jain AP, Pofee VW. A clinical evaluation of fine needle aspiration cytology in the diagnosis of lymphadenopathy. Ind J Tub. 1991;38: 17-9
Ling L, Zhou SH, Wang SQ. Changing trends in the clinical features of laryngeal tuberculosis: a report of 19 patients. Int J Infect Dis. 2010;14(3):230–5
Choudhury N, Bruch G, Kothari P, Rao G, Simo R. 4 years experience of head and neck tuberculosis in a South London Hospital. JR Soc Med. 2005; 98:267–9
Sahn SA, Davidson PT. Mycobacterium tuberculosis infection in the middle ear. Chest 1974; 66(1):104-06
S Bahadur, A Thakar. Specific chronic infections. In: Michael Gleeson, editor. Scott Brown’s otorhinolaryngology,head and neck surgery, 7th Ed. England: Hodder Arnold; 2008; 1458-60
Sriram R, Bhojwani KM. Manifestations of tuberculosis in Otorhinolaryngology practice: A retrospective study conducted in a coastal city of South India. Indian J Otolaryngol Head Neck Surg. 2017; 69(2):210-5
Dixit R, Sharma S, Nuwal P. Tuberculosis of oral cavity. Indian J Tuberc. 2008; 55(1):51-3
Yin TD, Wu W, Cao S, Li H. Analysis Of Misdiagnosis Of 4 Patients Of Tuberculosis Of Thyroid And Literature Review. Case Reports in Endocrinology (Internet). 2012 [cited 2015 Nov21]; 4 pages. doi:10.1155/2012/862595
Pandurang K, Sheno VS, Bhojwani K, Alva A, Prdead.V, et al. Tuberculosis in head and neck in India:down but not yet dead. .J Mycobac Dis. 2014; 4(2):148.doi:10.4172/2161-1068.1000148
Hafeez M, Inayatullah, Ahmad I, Zakirullah. Otorhinolaryngological manifestations of tuberculosis. Pak J Med Sci. 2011; 27(4):855–7
Das S, Das D, Bhuyan U, Saikia N. Head and neck tuberculosis:Scenerio in a tertiary care Hospital of North Eastern India. Journal of Clinical and Diagnostic Research, 2016; 10(1):MC04-MC07.