Nasopharyngeal tuberculosis

Nasopharyngeal tuberculosis used to be a common disease in the upper aerodigestive system. Before 1920, 1.4 and 6.5 per cent of all adenoids and tonsils removed from asymptomatic patients were infected by tuberculosis. After the introduction of antituberculous chemotherapy and BCG vaccination, this disease was considered uncommon and sporadic cases were reported in the medical literature. Recently, tuberculosis has begun to increase again due to the high global HIV-infected rate and antituberculous drug resistance among these people. To describe and highlight the clinical features of this condition, fifteen Thai patients (7 males and 8 females) from the Department of Otolaryngology, Siriraj Hospital, Bangkok, Thailand were reviewed. Cervical lymphadenopathy was the most common presenting symptom in our series (93.34%), 11 of them were classified as primary nasopharyngeal tuberculosis and most had abnormal nasopharyngeal findings by mirror examination except 2 cases. Although all had histopathological confirmation of nasopharyngeal tuberculosis, sometimes problems occur in the diagnosis between this disease and nasopharyngeal carcinoma, which are also common among Oriental people in many of their clinical similarities. Therefore routine nasopharyngeal biopsy is considered justified and diagnostic.