Pulmonary tuberculosis with rhinosinusal and otic manifestations - diagnostic challenge
Journal Title: Romanian Journal of Rhinology - Year 2019, Vol 9, Issue 35
Abstract
BACKGROUND. Unfortunately, tuberculosis is still being diagnosed among patients, independent of their age, gender, provenance or social category. The etiologic agent of tuberculosis is Mycobacterium tuberculosis, which is known to have a period of latency between the initial infection and the clinical manifestation. The most common localization is pulmonary, but it can affect, secondarily, other organs, especially in the ENT regions, mimicking other systemic diseases. MATERIAL AND METHODS. We are presenting a case of a 51-year-old female patient, who was referred to our ENT Clinic with the suspicion of Behcet’s disease with rhinosinusal manifestations. She had a pulmonary assessment in another hospital, as she was known with left lung bronchiectasis, but the sputum samples were negative. The clinical otorhinolaryngologic examination together with the rheumatological assessment and the result of the nasal mucosa biopsy were suggestive for Behcet’s disease and the patient received 6 weeks of Prednisolone. The specific immunologic tests (cANCA, pANCA, HLA B51) were negative. The patient returned to our clinic after 2 months, accusing symptomatology reacutization with right otorrhea and bilateral hearing loss aggravation. Nasal and rhinopharyngeal mucosa biopsies were repeated and the anatomopathological result was specific for tuberculosis. RESULTS. She was referred to the Pneumology Service where she received the diagnosis of pulmonary tuberculosis with rhinosinusal and otic manifestations. Currently, the patient is under tuberculostatic treatment. CONCLUSION. Extrapulmonary tuberculosis symptoms might be confused with other systemic diseases with rhinosinusal manifestations. Thorough examination and multidisciplinary approach are mandatory in order to establish a correct diagnosis followed by an appropriate treatment.
Authors and Affiliations
Codrut Sarafoleanu, Elena Patrascu, George Bacarna, Gabriela-Violeta Melinte
Keywords
Related Articles
- EP ID EP619124
- DOI 10.2478/rjr-2019-0019
- Views 62
- Downloads 0
Stent technique for endoscopic dacryocystorhinostomy – Our expertise
BACKGROUND. Endoscopic dacryocystorhinostomy is known to be the ideal treatment for saccal and postsaccal stenosis of the lacrimal apparatus. Following this surgery, an important inconvenient would be the stenosis of the...
The impact of gastroesophageal reflux in the ENT pathology
Frequently encountered in medical practice, the gastroesophageal reflux (GER) is a chronic condition characterized by the passage of gastric acid or gastric contents into the esophagus. In otorhinolaryngology, the diagno...
A rare case of triple-hit diffuse large B-cell lymphoma of the parotid gland in a patient with Sjogren’s syndrome
BACKGROUND. Primary malignant lymphomas of the salivary gland are rare, accounting for 2% of salivary gland tumors and 5% of all extranodal lymphomas. The clinical presentation is not particularly characteristic, a featu...
The diagnosis of a cervical tumefaction in children
Neck pathology in children involves many diseases with similar clinical expression. Different disorders in paediatric practice may be clinically manifested by a cervical tumefaction. The cervical tumefaction can be repre...
Sinonasal adenocarcinoma with aggressive ocular symptom
BACKGROUND. The malignant sinonasal tumour is very rare. Sinonasal adenocarcinoma comprises only 10-20% of all primary malignant sinonasal tumours. The commonest type is the maxillary squamous cell carcinoma. It commonly...