Primary nasal tuberculosis: diagnostic dilemma: a case report with role of GeneXpert

Mahender Singh, Trilok C. Guleria, Ramesh K. Azad, Narender K. Mohindroo


Tuberculosis of the nose is so rare that it has become a forgotten entity among the clinicians. The clinicians fail to diagnose primary nasal TB as symptoms and signs of this specific nasal inflammation mimic other nonspecific nasal inflammatory conditions and therefore, its diagnosis and treatment is often delayed. We came across a case of primary nasal TB in a 65 years old female presented with complaints of nasal obstruction, epistaxis and anosmia since past 3 years. Anterior rhinoscopy showed friable nasal mass in both nasal cavities. Computed tomography scan showed heterogeneously enhancing soft tissue in nasal cavity with destruction of the nasal septum and hard palate. Histopathological examination and GeneXpert confirmed mycobacterium tuberculosis. The patient was put on antituberculous therapy.Nasal endoscopy and tissue biopsy play important role in diagnosis of the disease. GeneXpert test not only has good sensitivity and specificity for the diagnosis of EPTB but also perfectly fits the requirements of the Indian health care setting.


Histopathology, Nasal, Tuberculosis, Primary, Extra-pulmonary

Full Text:



Waldman SR, Levine HL, Sebek BA, Parker W, Tucker HM. Nasal tuberculosis: A forgotten entity. Laryngoscope. 1981;91:11‑6.

Kameswaran M, Anand Kumar RS, Murali S, Raghunandan S, Vijaya Krishnan P. Primary nasal tuberculosis – A case report. Indian J Otolaryngol Head Neck Surg. 2007;59:87‑9.

Nayar RC, Al Kaabi J, Ghorpade K. Primary nasal tuberculosis: A case report. Ear Nose Throat J. 2004;83:188‑91.

Pust RE. Tuberculosis in the 1990’s: resurgence, regimens, and resources. South Med J. 1992;85(6):584-93.

Goguen LA, Karmody CS. Nasal tuberculosis. Otolaryngol Head Neck Surg. 1995;113(1):131‑5.

Butt AA. Nasal tuberculosis in the 20th century. Am J Med Sci. 1997;313:332‑5.

Prasad KC, Sreedharan S, Chakravarthy Y, Prasad SC. Tuberculosis in the head and neck: experience in India. J Laryngol Otol. 2007;121(10):979-85.

Dixit R, Dave L. Primary nasal tuberculosis. Lung India. 2008;25(2):102‑3.

Vadwai V, Boehme C, Nabeta P, Shetty A, Alland D, Rodrigues C. Xpert MTB/RIF: A New Pillar in Diagnosis of Extrapulmonary Tuberculosis? J Clin Microbiol. 2011,49(7):2540–5.