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Secondary laryngeal tuberculosis revisited.

Lodha JV, Sharma A, Virmani N, Bihani A, Dabholkar JP - Lung India (2015 Sep-Oct)

Bottom Line: All the four patients who presented to us with hoarseness had underlying active lesions in the lung.A diagnosis could be established owing to a high index of clinical suspicion, and due consideration given to the chest findings and positive sputum examination.The patients showed an excellent response to antituberculous therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of ENT and Head and Neck Surgery, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India.

ABSTRACT

Introduction: Laryngeal tuberculosis is often misdiagnosed and is a highly contagious public health problem. The changing pattern of the clinical involvement of this disease poses a diagnostic challenge. The authors report four cases of laryngeal tuberculosis encountered in a short span of one month.

Materials and methods: All the four patients who presented to us with hoarseness had underlying active lesions in the lung. In spite of that they presented with mainly laryngeal symptoms and a multitude of findings on laryngeal examination. A diagnosis could be established owing to a high index of clinical suspicion, and due consideration given to the chest findings and positive sputum examination. The patients showed an excellent response to antituberculous therapy.

Results and conclusions: This study underlines the varied nature of laryngeal tuberculosis and the importance of addressing the hoarseness of a patient at the earliest, for the prompt diagnosis of this infectious condition.

No MeSH data available.


Related in: MedlinePlus

(a) Chest x-ray suggestive of cavitatory lesions in the lung. (b) HRCT chest suggestive of cavitatory lesions in the lung
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Figure 3: (a) Chest x-ray suggestive of cavitatory lesions in the lung. (b) HRCT chest suggestive of cavitatory lesions in the lung

Mentions: Contrast-enhanced computerized tomography (CECT) scan of the neck highlighted mucosal irregularity and thickening over the bilateral vocal cords in three patients [Figure 2]. Chest x-ray and high-resolution computed tomography (HRCT) chest revealed cavitatory lesions [Figure 3a and b]. The sputum smear was positive for acid fast bacilli (AFB) in all four patients. Considering the typical laryngeal diffuse findings clubbed with the chest x-ray and HRCT findings along with a positive sputum AFB report, all four patients were diagnosed to have secondary laryngeal tuberculosis, due to the seedlings of the bacilli in the larynx from the pulmonary lesion. They were started on category-1 antituberculous therapy. Category 1 consisted of isoniazid, rifampicin, pyrazinamide, and ethambutol for two months followed by isoniazid and rifampicin for another four months. The symptoms as well as laryngeal findings completely resolved within two months of starting the treatment and the patients’ sputum AFB was negative at the end of two months of starting ATT, with moderately resolved cough and improved general condition.


Secondary laryngeal tuberculosis revisited.

Lodha JV, Sharma A, Virmani N, Bihani A, Dabholkar JP - Lung India (2015 Sep-Oct)

(a) Chest x-ray suggestive of cavitatory lesions in the lung. (b) HRCT chest suggestive of cavitatory lesions in the lung
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587000&req=5

Figure 3: (a) Chest x-ray suggestive of cavitatory lesions in the lung. (b) HRCT chest suggestive of cavitatory lesions in the lung
Mentions: Contrast-enhanced computerized tomography (CECT) scan of the neck highlighted mucosal irregularity and thickening over the bilateral vocal cords in three patients [Figure 2]. Chest x-ray and high-resolution computed tomography (HRCT) chest revealed cavitatory lesions [Figure 3a and b]. The sputum smear was positive for acid fast bacilli (AFB) in all four patients. Considering the typical laryngeal diffuse findings clubbed with the chest x-ray and HRCT findings along with a positive sputum AFB report, all four patients were diagnosed to have secondary laryngeal tuberculosis, due to the seedlings of the bacilli in the larynx from the pulmonary lesion. They were started on category-1 antituberculous therapy. Category 1 consisted of isoniazid, rifampicin, pyrazinamide, and ethambutol for two months followed by isoniazid and rifampicin for another four months. The symptoms as well as laryngeal findings completely resolved within two months of starting the treatment and the patients’ sputum AFB was negative at the end of two months of starting ATT, with moderately resolved cough and improved general condition.

Bottom Line: All the four patients who presented to us with hoarseness had underlying active lesions in the lung.A diagnosis could be established owing to a high index of clinical suspicion, and due consideration given to the chest findings and positive sputum examination.The patients showed an excellent response to antituberculous therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of ENT and Head and Neck Surgery, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India.

ABSTRACT

Introduction: Laryngeal tuberculosis is often misdiagnosed and is a highly contagious public health problem. The changing pattern of the clinical involvement of this disease poses a diagnostic challenge. The authors report four cases of laryngeal tuberculosis encountered in a short span of one month.

Materials and methods: All the four patients who presented to us with hoarseness had underlying active lesions in the lung. In spite of that they presented with mainly laryngeal symptoms and a multitude of findings on laryngeal examination. A diagnosis could be established owing to a high index of clinical suspicion, and due consideration given to the chest findings and positive sputum examination. The patients showed an excellent response to antituberculous therapy.

Results and conclusions: This study underlines the varied nature of laryngeal tuberculosis and the importance of addressing the hoarseness of a patient at the earliest, for the prompt diagnosis of this infectious condition.

No MeSH data available.


Related in: MedlinePlus