Isolated Extra-Pulmonary Tuberculosis in ENT: A Commonly Missed Diagnosis

Area of Science:

• Infectious Diseases
• Otolaryngology
• Oncology

Background:

• Tuberculosis (TB) represents a significant portion of general practice cases in India, particularly among HIV-negative adults.
• The head and neck region is a notable site for TB due to its diverse manifestations and potential for misdiagnosis as malignancy.
• Extrapulmonary TB (EPTB) in this region requires focused clinical attention due to its varied presentations.

Purpose of the Study:

• To highlight the diverse clinical presentations of isolated extrapulmonary TB in the head and neck region.
• To emphasize the importance of early diagnosis and high clinical suspicion for EPTB in head and neck cases.
• To discuss diagnostic modalities and management considerations for EPTB in the head and neck.

Main Methods:

• Prospective analysis of 60 patients diagnosed with TB over one year (July 2022 - June 2023).
• Patients presenting to the ENT Outpatient Department of Civil Hospital, Asarwa, with complete clinical data were included.
• Simple random sampling was employed for patient selection.

Main Results:

• The most commonly affected age group was the 3rd and 4th decades of life, with a male predominance.
• Cervical lymphadenitis was the most frequent presentation of EPTB in the head and neck, followed by tuberculous otitis media and laryngeal TB.
• Fine needle aspiration cytology (FNAC) was identified as an efficient diagnostic tool.

Conclusions:

• EPTB in the head and neck presents with characteristic clinical features, including cervical lymphadenitis, otitis media, and laryngeal TB.
• A high index of suspicion and prompt diagnosis are essential to prevent disease progression and complications.
• FNAC is a valuable diagnostic method for EPTB in the head and neck region.