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A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region

Indian Journal of Otolaryngology and Head & Neck Surgery volume 66, pages 46–50 (2014)Cite this article

Abstract

Though tuberculosis (TB) primarily affects lungs, extra pulmonary tuberculosis (EPTB) is also common, especially in high disease load areas and mainly manifests in ENT region. To study the different manifestations of tuberculosis in ENT region in terms of presentation, disease process, treatment and outcome. Records of patients diagnosed and treated for TB in the ENT region at our institute’s DOTS centre for a two and half year period were analysed for presenting complaints, examination findings, diagnostic features, treatment modes and outcome. Out of 3750 cases diagnosed as TB, 230 had EPTB. 211 cases had ENT manifestations. Majority of the cases were male and in the fourth decade of life. Commonest manifestation was cervical lymphadenopathy with 201 cases. Fine needle aspiration cytology was mostly diagnostic and category I anti TB treatment (AKT) achieved cure. The six cases of TB otitis media presented with ear discharge, sometimes bloody and had varied tympanic membrane findings and facial palsy in two cases with different types and degrees of hearing loss. Diagnosis was confirmed by histology of tissue removed during surgery. Patients completed category I AKT. Hearing and facial palsy did not improve. There were three cases of TB laryngitis and one of nasal TB both of which were confirmed by tissue diagnosis and responded well to AKT. Most of the results in the present study conform to findings of other studies. High degree of suspicion is necessary to reach diagnosis. Category I AKT is effective. Some cases may require surgery.

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References

  1. de Sousa RT, Briglia MFS, de Lima LCN, de Carvalho RS, Teixeira ML, Marcião AHR (2010) Frequency of Otorhinolaryngologies’manifestations in patients with pulmonary tuberculosis. Int Arch Otorhinolaryngol 14(2):156–162

    Google Scholar 

  2. Mazza-Stalder J, Nicod L, Janssens JP (2012) Extrapulmonary tuberculosis. Rev Mal Respir 29(4):566–578

    CAS  PubMed  Article  Google Scholar 

  3. Le Roux P, Quinque K, Bonnel AS, Le Luyer B (2005) Extra-pulmonary tuberculosis in childhood. Arch Pediatr 12(Suppl 2):S122–S126

    PubMed  Article  Google Scholar 

  4. Stelianides S, Belmatoug N, Fantin B (1997) Manifestations and diagnosis of extrapulmonary tuberculosis. Rev Mal Respir 14(Suppl 5):S72–S87

    PubMed  Google Scholar 

  5. Hup AK, Haitjema T, de Kuijper G (2001) Primary nasal tuberculosis. Rhinology 39:47–48

    CAS  PubMed  Google Scholar 

  6. Chakravorty S, Sen MK, Tyagi JS (2005) Diagnosis of extrapulmonary tuberculosis by smear, culture, and PCR using universal sample processing technology. J Clin Microbiol 43(9):4357–4362

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  7. Bayazit YA, Bayazit N, Namiduru M (2004) Mycobacterial cervical lymphadenitis. ORL J Otorhinolaryngol Relat Spec 66(5):275–280

    PubMed  Article  Google Scholar 

  8. Pinho MM, Kós AOA (2003) Otite Média Tuberculosa, Artigo deRevisão. Rev Bras Otorrinol 68(5):829–837

    Google Scholar 

  9. Mohan A, Reddy KM, Phaneendra BV, Chandra A (2007) Aetiology of peripheral lymphadenopathy in adults: analysis of 1724 cases seen at a tertiary care teaching hospital in southern India. Natl Med J India 20(2):78–80

    PubMed  Google Scholar 

  10. Abes GT, Abes FL, Jamir JC (2011) The variable clinical presentation of tuberculosis otitis media and the importance of early detection. Otol Neurotol 32(4):539–543

    PubMed  Article  Google Scholar 

  11. Yaniv E (1987) Tuberculous otitis: an underdiagnosed disease. Am J Otolaryngol 8(6):356–360

    CAS  PubMed  Article  Google Scholar 

  12. Adhikari P (2009) Tuberculous otitis media: a review of literature. Internet J Otorhinolaryngol 9(1):7. doi:10.5580/1b78

    Google Scholar 

  13. Yaniv E, Traub P, Conradie R (1986) Middle ear tuberculosis–a series of 24 patients. Int J Pediatr Otorhinolaryngol 12(1):59–63

    CAS  PubMed  Article  Google Scholar 

  14. Kirsch CM, Wehner JH, Jensen WA, Kagawa FT, Campagna AC (1995) Tuberculous otitis media. South Med J 88(3):363–366

    CAS  PubMed  Article  Google Scholar 

  15. Yencha MW, Linfesty R, Blackmon A (2000) Laryngeal tuberculosis. Am J Otolaryngol 21(2):122–126

    CAS  PubMed  Article  Google Scholar 

  16. Essaadi M, Raji A, Detsouli M, Mokrim B, Kadiri F, Laraqui NZ et al (2001) Laryngeal tuberculosis: apropos of 15 cases. Rev Laryngol Otol Rhinol (Bord) 122(2):125–128

    CAS  Google Scholar 

  17. Levenson MJ, Ingerman M, Grimes C, Robbett WF (1984) Laryngeal tuberculosis: review of twenty cases. Laryngoscope 94(8):1094–1097

    CAS  PubMed  Article  Google Scholar 

  18. Pino Rivero V, Marcos García M, González Palomino A, Trinidad Ruiz G, Pardo Romero G, Pimentel Leo JJ, Blasco Huelva A (2005) Laryngeal tuberculosis masquerading as carcinoma. Report of one case and literature review. An Otorrinolaringol Ibero Am 32(1):47–53

  19. de Bree R, Chung RP, van Aken J, van den Brekel MW (1998) Tuberculosis of the larynx. Ned Tijdschr Geneeskd 142(29):1676–1680

    PubMed  Google Scholar 

  20. Galietti F et al (1989) Examination of 41 cases of laryngeal tuberculosis observed between 1975–1985. Eur Respir J 2(8):731–732

    CAS  PubMed  Google Scholar 

  21. Windle-Taylor P, Bailey CM (1980) Tuberculous otitis media: a series of 22 patients. Laryngoscope 90:1039–1044

    CAS  PubMed  Google Scholar 

  22. Dixit R, Dave L (2008) Primary nasal tuberculosis. Lung India 25:102–103

    PubMed Central  PubMed  Article  Google Scholar 

  23. Kim YM, Kim AY, Park YH, Kim DH, Rha KS (2007) Eight cases of nasal tuberculosis. Otolaryngol Head Neck Surg 137(3):500–504

    PubMed  Article  Google Scholar 

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Affiliations

  1. Deparment of Respiratory Medicine, Smt. B. K. Shah Medical Institute & Research Centre, Piparia, Waghodia, Vadodara, 391760, Gujarat, India

    Stani Ajay Akkara, Arti Shah & Mayur Adalja

  2. Department of ENT, Smt. B. K. Shah Medical Institute & Research Centre, Piparia, Waghodia, Vadodara, 391760, Gujarat, India

    Ankit Singhania, Ajay George Akkara & Nirali Chauhan

  3. C-1, Staff Quarters, Sumandeep Vidyapeeth Campus, Vadodara, 391760, Gujarat, India

    Ajay George Akkara

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  1. Stani Ajay Akkara
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  2. Ankit Singhania
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  3. Ajay George Akkara
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  4. Arti Shah
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Correspondence to Ajay George Akkara.

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Akkara, S.A., Singhania, A., Akkara, A.G. et al. A Study of Manifestations of Extrapulmonary Tuberculosis in the ENT Region. Indian J Otolaryngol Head Neck Surg 66, 46–50 (2014). https://doi.org/10.1007/s12070-013-0661-7

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  • DOI: https://doi.org/10.1007/s12070-013-0661-7

Keywords

  • Tuberculosis
  • Cervical lymphadenopathy
  • Tuberculous otitis media
  • Tuberculous laryngitis
  • Nasal tuberculosis