Tuberculosis of the head and neck in Finland

Tuberculosis is a rare disease that can mimic a neck malignancy. It should be taken into consideration when evaluating a patient with a neck mass, especially when the patient has come from an area of high endemic incidence. Another risk group comprises older people with dormant tuberculosis.

We wanted to find out the incidence of head and neck tuberculosis in Finland and to define the factors that should make one suspect it.

This was a retrospective analysis of patients who were diagnosed with tuberculosis in the Department of Otolaryngology, Helsinki University Central Hospital (population base c.a. 1,000,000) during 1996-2005. All the patients with culture- or PCR-positive tuberculosis were included.

During 1996-2005, 63 patients were diagnosed with head and neck tuberculosis, the average incidence being 0.6/100,000 per year. The age of the patients varied between 3 and 94 years (mean 47 years). The mean age of patients who were of Finnish extraction (37 patients) was 62 years and that of immigrants (26 patients) was 27 years. Forty-four (70%) patients were female and 19 (30%) male. The majority of patients presented with a neck mass without symptoms of general infection such as fever or fatigue.