DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20201302

A rare case of primary nasal tuberculosis

George M. V., Lina Theresa, Aswathi R.

Abstract


Even though tuberculosis is not uncommon, primary nasal tuberculosis is extremely rare. This is the story of a 46 years old man, diabetic, who had not any chest symptoms suggestive of tuberculosis, presented to us with nasal block, sneezing for a long time. The symptoms didn't improve with the usual lines of management from Dubai where he was working.  When we saw the patient, he had a deviated nasal septum towards right side, and highly boggy pale mucosa of the nose with mucoid discharge on left side.  He was on antibiotics for a long time. Hence a CT scan was taken. The CT scan showed typical features of sinusitis. Therefore, he was advised septoplasty with functional endoscopic sinus surgery (FESS). On surgery, the inferior turbinate was seen boggy with pale mucosa. It obscured the vision of the middle turbinate. There was granuloma on the turbinate. This was taken for biopsy and the report was granulomatous tissue with areas of necrosis and the possibility of tuberculosis is there. His blood samples were negative for other granulomatous disease and therefore was advised antituberculosis treatment. His symptoms improved. There was no evidence of a pulmonary tuberculosis in the chest and therefore was diagnosed as a case of primary nasal tuberculosis.


Keywords


Extra pulmonary tuberculosis, Primary nasal tuberculosis, FESS

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References


Sagar P, Wadhwa V, Singh I, Mallya V, Rajpurohit P. Naso-Septal Tuberculosis Mimicking Dermoid in a 3 years old Child. Iranian J otorhinolaryng. 2018;30(99):231.

Kameswaran M, Kumar RA, Murali S, Raghunandan S, Krishnan PV. Primary nasal Tuberculosis: a case report. Indian J Otolaryng Head Neck Surg. 2007;59(1):87-9.

Singh M, Guleria TC, Azad RK, Mohindroo NK. Primary nasal tuberculosis: diagnostic dilemma: a case report with role of GeneXpert. Int J of Otorhinolaryng Head Neck Surg. 2018;4(2):2454-5929.

Kim KY, Bae JH, Park JS, Lee SS. Primary sinonasal tuberculosis confined to the unilateral maxillary sinus. Int J Clin Experim Pathology. 2014;7(2):815.

Singh M, Guleria TC, Azad RK, Mohindroo NK. Primary nasal tuberculosis: diagnostic dilemma: a case report with role of GeneXpert. Int J Otorhinolaryng Head Neck Surg. 2018;4(2):591.

Kumar S, Passey JC, Mandai AK. Primary tuberculosis of nasal septum. Indian J Otolaryng Head Neck Surg. 1999;51(1):78.

Lai TY, Liu PJ, Chan LP. Primary nasal tuberculosis presenting with septal perforation. J Formosan Med Assoc. 2007;106(11):953-5.

Kant S, Srivastava R, Verma AK, Singh HP, Singh S, Ranganath TG, et al. Maxillary sinus tuberculosis: various presentations. Indian J Chest Dis Allied Sci. 2013;55(3):175-77.

Chakravarti A, Dhawan R, Shashidhar TB, Sahni JK. Lupus vulgaris of external nose. Indian J Tubercul. 2006;53(4):220.

Raviglione M, Richard J, Brien O, Longo DL, Anthony S, Fauci et al. Tuberculosis, Harrison ‘s Principles of Internal Medicine. 18th edition. New York: McGraw Hill Medical; 1340-1358.