Upper respiratory tract tuberculosis. Sixteen cases in a general hospital.

Abstract

Sixteen patients (1.8%) with upper respiratory tract tuberculosis were identified among 843 admissions for tuberculosis. In 11 patients tuberculous laryngitis was present alone or in combination with tuberculosis of the epiglottis, pharynx, tonsils, or soft palate. The other five patients had tuberculous otitis media, tuberculous tonsillitis, and tuberculous ulcerations of the tongue and pharynx. In each patient smears of sputum concentrates were positive for acid-fast bacilli, and chest roentgenograms suggested active tuberculosis. Tuberculosis of the larynx was often misdiagnosed as carcinoma of the larynx in patients with hoarseness and weight loss. Helpful findings included productive cough, pulmonary rales, and the absence of cervical lymphadenopathy, which is commonly found in laryngeal carcinoma. Complications included tuberculous enteritis and upper-airway obstruction. Tuberculous laryngitis is the most infectious form of the disease; thorough physical examination and chest roentgenographic study should precede laryngoscopic examination of patients in whom tuberculosis may seem to be carcinoma of the larynx.