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Pulmonary tuberculosis with rhinosinusal and otic manifestations - diagnostic challenge Cover

Pulmonary tuberculosis with rhinosinusal and otic manifestations - diagnostic challenge

Open Access
|Jul 2019

Abstract

BACKGROUND. Unfortunately, tuberculosis is still being diagnosed among patients, independent of their age, gender, provenance or social category. The etiologic agent of tuberculosis is Mycobacterium tuberculosis, which is known to have a period of latency between the initial infection and the clinical manifestation. The most common localization is pulmonary, but it can affect, secondarily, other organs, especially in the ENT regions, mimicking other systemic diseases.

MATERIAL AND METHODS. We are presenting a case of a 51-year-old female patient, who was referred to our ENT Clinic with the suspicion of Behcet’s disease with rhinosinusal manifestations. She had a pulmonary assessment in another hospital, as she was known with left lung bronchiectasis, but the sputum samples were negative. The clinical otorhinolaryngologic examination together with the rheumato-logical assessment and the result of the nasal mucosa biopsy were suggestive for Behcet’s disease and the patient received 6 weeks of Prednisolone. The specific immunologic tests (cANCA, pANCA, HLA B51) were negative. The patient returned to our clinic after 2 months, accusing symptomatology reacutization with right otorrhea and bilateral hearing loss aggravation. Nasal and rhinopharyngeal mucosa biopsies were repeated and the anatomopathological result was specific for tuberculosis.

RESULTS. She was referred to the Pneumology Service where she received the diagnosis of pulmonary tuberculosis with rhinosinusal and otic manifestations. Currently, the patient is under tuberculostatic treatment.

CONCLUSION. Extrapulmonary tuberculosis symptoms might be confused with other systemic diseases with rhinosinusal manifestations. Thorough examination and multidisciplinary approach are mandatory in order to establish a correct diagnosis followed by an appropriate treatment.

DOI: https://doi.org/10.2478/rjr-2019-0019 | Journal eISSN: 2393-3356 | Journal ISSN: 2069-6523
Language: English
Page range: 155 - 159
Submitted on: Mar 2, 2019
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Accepted on: Apr 23, 2019
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Published on: Jul 30, 2019
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2019 Codrut Sarafoleanu, Elena Patrascu, George Bacarna, Gabriela - Violeta Melinte, published by Romanian Rhinologic Society
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.