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Laryngeal Tuberculosis

Laryngeal Tuberculoses


Presentation

  • We present a case of granulomatous laryngeal TB, in a 40 year old male, with characteristic presenting features of laryngeal carcinoma i.e. persistent hoarseness and weight loss.[ncbi.nlm.nih.gov]
  • This presentation consists of a detailed analysis of 20 cases, and a discussion of the incidence, pathogenesis, clinical presentation and management of laryngeal tuberculosis.[ncbi.nlm.nih.gov]
  • We present a case of a 57-year-old male patient, who presented in extremis with audible stridor, increased work of breathing and cyanosis.[ncbi.nlm.nih.gov]
  • In our population of 146 patients with TB involving the head and neck, HIV infection was present in 70 cases (48%). The prevalence of laryngeal TB in this population was 5.5% (8 patients).[ncbi.nlm.nih.gov]
  • Diabetes mellitus was present in seven (26.9 per cent) patients. Four illustrative cases are described. The problems in diagnosis and management of laryngeal tuberculosis are discussed.[ncbi.nlm.nih.gov]
Localized Pain
  • Patients usually present with hoarseness or dysphagia and other nonspecific constitutional symptoms like fever or localized pain. In this study, we present a case of primary vocal cord lesion with tuberculosis.[caspjim.com]
Movement Disorder
  • Rosen classified dysphonia into four different categories: functional voice disorders, organic voice disorders, movement disorders, and hoarseness caused by systemic diseases [5].[degruyter.com]
Down Syndrome
  • Abnormal serum IgG subclass pattern in children with Down's syndrome. Arch Dis Child 1992;67:628-31.[journals.lww.com]
Increased Susceptibility to Infections
  • susceptibility to infections, because of defects in the inflammatory response and cellular and humoral immunity, among others. 18 Laryngeal tuberculosis can occur regardless of Calmette-Guérin bacillus immunization status and result of the tuberculin[journals.lww.com]
Cervical Lymphadenopathy
  • There was no cervical lymphadenopathy or clubbing. There were no scars or sinuses in the neck. Indirect laryngoscopy had shown a grayish tumor in left supraglottic region. Vocal folds were moving with no signs of infiltration.[lungindia.com]
Mediastinal Lymphadenopathy
  • Tuberculous mediastinal lymphadenopathy can cause left vocal cord paralysis. Br Med J (Clin Res Ed). 1983;286:1562. Navani N, Molyneaux PL, Breen RA, Connell DW, Jepson A, Nankivell M, et al.[ijorl.com]
Hoarseness
  • A high index of suspicion for laryngeal TB is required in patients who present with hoarseness.[ncbi.nlm.nih.gov]
  • A 57-year-old male had presented only with hoarseness. Radiological findings were indicative of suspected metastasis from a malignant tumor.[ncbi.nlm.nih.gov]
  • We report two renal transplant recipients with laryngeal tuberculosis who presented with prolonged hoarseness of voice and painful dysphagia. Acid-fast bacilli were demonstrated on laryngeal biopsy and smear.[ncbi.nlm.nih.gov]
  • It should be considered in the differential diagnosis of patients presenting with chronic hoarseness. Two patients with laryngeal tuberculosis are the objective of the present report.[ncbi.nlm.nih.gov]
  • Although a rare entity, laryngeal tuberculosis must be a diagnostic consideration--along with laryngeal carcinoma--whenever patients present with prolonged hoarseness or painful dysphagia.[ncbi.nlm.nih.gov]
Hoarseness
  • A high index of suspicion for laryngeal TB is required in patients who present with hoarseness.[ncbi.nlm.nih.gov]
  • A 57-year-old male had presented only with hoarseness. Radiological findings were indicative of suspected metastasis from a malignant tumor.[ncbi.nlm.nih.gov]
  • We report two renal transplant recipients with laryngeal tuberculosis who presented with prolonged hoarseness of voice and painful dysphagia. Acid-fast bacilli were demonstrated on laryngeal biopsy and smear.[ncbi.nlm.nih.gov]
  • It should be considered in the differential diagnosis of patients presenting with chronic hoarseness. Two patients with laryngeal tuberculosis are the objective of the present report.[ncbi.nlm.nih.gov]
  • Although a rare entity, laryngeal tuberculosis must be a diagnostic consideration--along with laryngeal carcinoma--whenever patients present with prolonged hoarseness or painful dysphagia.[ncbi.nlm.nih.gov]
Decreased Breath Sounds
  • Severe dysphonia was noticed and his pulmonary auscultation was remarkable for decreased breath sounds and bilateral rales. Small nontender, superficial and bilateral cervical lymph nodes were palpable.[journals.lww.com]
Hematochezia
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis Case 4-2019: An 18-Year-Old Man with Abdominal Pain and Hematochezia Bridging the Gap Challenge Yourself[nejm.org]
Paresis
  • Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis) or functional (functional dysphonia, laryngeal conversion disorder, paradoxical vocal folds motion) conditions.[degruyter.com]

Workup

Acid-Fast Bacilli in the Sputum
  • Ziehl-Neelsen staining of the tissue biopsies and sputum revealed acid-fast bacilli (Figure 3B ). Sputum culture turned out to be positive for Mycobacterium tuberculosis.[jmedicalcasereports.biomedcentral.com]
  • In that case, acid fast bacilli in the sputum infect laryngeal mucosa via direct contact. That way, the posterior part of the larynx is affected most often with disease gradually progressing to the other parts of the larynx.[degruyter.com]
  • All were suffering from pulmonary tuberculosis confirmed by abnormal chest x-rays, elevated ESR and predilection for laryngeal involvement was not demon- presence of acid fast bacilli in the sputum smear.[jpma.org.pk]
Granulomatous Tissue
  • Granulomatous tissue was present in the posterior commissure. Biopsies from the area confirmed TB.[4] Discussion: This case presents a threat to health care workers and other patients if TB antibiotics were not timeously given.[epostersonline.com]

Treatment

  • An obvious improvement in acoustic analytical parameters was also found following treatment.[ncbi.nlm.nih.gov]
  • Although rare and more commonly used in the treatment of sleep apnea, palatopharyngoplasty can be a viable option for the treatment of naso-oropharyngeal stenosis and should be kept in the armamentarium of reconstructive craniofacial surgeons.[ncbi.nlm.nih.gov]
  • In laryngeal tuberculosis patients with dysphonia, laryngeal tuberculosis treatment resulted in dysphonia resolution in only 15.8 per cent.[ncbi.nlm.nih.gov]
  • Before treatment (at top), c. the 2 nd month of treatment (lower left), d. 6 th month of treatment (lower right). Videostroboscopic views: a. 8 th month of treatment (left), b. 2 months after treatment (right). The vocal assessment programme of Dr.[ncbi.nlm.nih.gov]
  • Treatment with a combination of isoniazid, rifampicin, pyrazinamide, and ethambutol led to a complete resolution of symptoms. A high index of suspicion for laryngeal TB is required in patients who present with hoarseness.[ncbi.nlm.nih.gov]

Prognosis

  • Extensive laser excision before diagnosis should be avoided because after antituberculous treatment, prognosis is usually good and vocal fold immobility could be reversible.[ncbi.nlm.nih.gov]
  • Before anti-tubercular drug use, in the 1950’s, it was a common and frequently fatal disease but it’s clinical features, age group involved and prognosis has changed over the last few decades.[scopemed.org]
  • An antituberculous therapy offers a good prognosis, generally curing the disease without any sequel. Most lesions disappear over a 2-month period, as in the present case.[lungindia.com]
  • Antitubercular therapy offers a good prognosis. This patient became asymptomatic after one month of chemotherapy. Conclusion Laryngeal tuberculosis is no more a rare condition, with the incidence of 4% among all cases of tuberculosis.[tjmrjournal.org]
  • .• Painless asymptomatic condition may be discovered incidentally• Prognosis is good• Treatment is anti tubercular drugs 21. MYCOSIS OF LARYNX• Following mycosis can occur in the larynx1. Candidiasis2. Coccidioidmycosis3. Paracoccidioidmycosis4.[slideshare.net]

Etiology

  • Although tuberculosis and carcinoma may be indistinguishable clinically and radiographically, specific radiographic studies better delineate the lesion and may suggest its true etiology. Five cases of laryngeal tuberculosis referred to M.D.[ncbi.nlm.nih.gov]
  • […] immunosuppressive treatments. 2,3 Although the pulmonary system is most commonly affected, extrapulmonary involvement occurs in sites that include the lymphatics, pleura, bone, genitourinary system, meninges, peritoneum and larynx. 4,5 There are two theories on the etiology[enttoday.org]

Epidemiology

  • There are many important changes incorporated into this edition, including the dramatic effect of AIDS on the incidence and clinical mani festations of mycobacterial infection, new developments in epidemiology and bacteriology, and thoroughly updated[books.google.de]
  • Difference in transmissibility between bronchial and laryngeal tuberculosis – A retrospective epidemiological study of TB patients newly registered in recent 19 years in Aichi Prefecture, Japan. Kekkaku. 2006;81(6):419-24.[ijmedicine.com]
  • Epidemiological considerations and clinical features of ENT tuberculosis. J Laryngol Otol 2001;115(7):555–8. [ CrossRef ] [ Pubmed ] Fernandes L, Mesqnita A. Stridor presentation in laryngeal tuberculosis. Indian J Tuberc 1997;44:93–4.[ijcasereportsandimages.com]
  • Epidemiology of tuberculosis in the United States, 1985 through 1992. JAMA 1994;272:535-9. 3. Chavalittamrong B, Ratanarapee S, Vitavasiri A, Talalak P. Tuberculous laryngitis in childhood. J Med Assoc Thai 1982;65:388-94. 4.[journals.lww.com]
  • Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis. 2009;49(9):1350-1357. Yencha MW, Linfesty R, Blackmon A. Laryngeal tuberculosis. Am J Otolaryngol. 2000;21(2):122-126. Auerbach O. Laryngeal tuberculosis.[enttoday.org]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology and natural course of the disease are discussed. The incidence of apical tuberculosis and associated laryngeal spread is noted.[ncbi.nlm.nih.gov]

Prevention

  • It is necessary to detect the disease early to prevent the development of severe sequalae or mortality.[ncbi.nlm.nih.gov]
  • We studied the prevention of secondary infections of laryngeal tuberculosis.[jstage.jst.go.jp]
  • Pulmonary imaging study should be performed for early diagnosis and to prevent the infection from spreading. Copyright 2015 Elsevier Ireland Ltd. All rights reserved.[ncbi.nlm.nih.gov]
  • As with the first edition, it is hoped that this text will continue to represent a definitive resource for both the basic scientist and the clinician who deal with the prevention and treatment of mycobacterial infection.[books.google.de]
  • After the introduction of antituberculous agents, preventive programs and better socioeconomic conditions, TB incidence decreased dramatically up until the 1980s [ 1 – 4 ].[jmedicalcasereports.biomedcentral.com]

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