Diagnostic dilemmas of head and neck tuberculosis: our experience and review of literature
Keywords:Extrapulmonary tuberculosis, Head and neck, Larynx, Lymph nodes, Ear, Mastoiditis
Background: The aim of the study was to highlight the varied and changing presentations of head and neck tuberculosis, discuss the difficulties in diagnosis and treatment.
Methods: This was a 5 years retrospective analysis of patients with extrapulmonary tuberculosis (EPTB) of the head and neck region.
Results: 54 patients with EPTB were studied. Most had cervical lymphadenopathy (35), 9 had laryngeal, 7 tuberculous otitis media, and one patient each of PNS, oropharyngeal and retropharyngeal involvement. 8 patients had pulmonary TB, 2 had Potts spine, and 5 gave history of previous TB. FNAC was effective in nodal disease, PPD test positive in 11% and HPE was used to make the diagnosis in other types.
Conclusions: TB is re-emerging as a significant cause of morbidity. Diagnosing EPTB requires high index of suspicion. Cervical lymphadenopathy is the commonest presentation, followed by larynx, and then ear. FNAC is a reliable and convenient way to diagnose lymphadenopathy. Hitopathological examination needed for confirmation, and for other sites. Further investigations are needed to exclude pulmonary or systemic TB. All patients should be categorised into proper category of anti-tuberculous treatment (ATT) and treated according to ATT regimen.
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