LARYNGEAL TUBERCULOSIS

Abstract

Laryngeal Tuberculosis (LT) is a rare disease that represents less than 2% of cases of extrapulmonary tuberculosis and is the most frequent granulomatous disease in the larynx. The diagnosis is possible from the histopathological and microbiological analysis of laryngeal lesion fragments obtained by biopsy. However, the recognition is often difcult due to the varied clinical symptoms, often, limited to dysphonia and odynophagia, while typical tuberculosis symptoms such as fever, cough and night sweats are absent. The purpose of the present study is to report a case of laryngeal tuberculosis in order to reduce under diagnosis rates and inappropriate treatment. In this study, a 39 year-old female presented at rst only dysphagia and dry cough, no history of fever or weight loss, sputum culture negative for Mycobacterium tuberculosis and chest X-ray without signs of pulmonary involvement. However, patient underwent otorhinolaryngological evaluation through laryngoscopy, which revealed destructive, vegetative, inltrative growth involving epiglottis, arytenoids, vestibular folds and bilateral aryepiglottic folds on the larynx; however, only received anti-inammatory treatment, which did not relieve symptoms. After 6 months, the patient complained of fever, dysphagia, sialorrhea, and gagging, productive cough, dysphonia and weight loss of 6kgs. One month later, histopathology of laryngeal biopsy revealed chronic granulomatous inammation, suggesting tuberculosis. Thus, the patient was immediately started on the standard four-drug anti tuberculosis (anti-TB), evidencing on the follow-up symptomatically improvement with treatment.