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[一名内科医生原发性喉结核病例的病理及分子诊断]

[Pathological and molecular diagnosis in a case of primary laryngeal tuberculosis in a physician].

作者信息

Jurado Leonardo F, Palacios Diana M, Alvarez Johanna, Baldión Margarita, Campos Guillermo

机构信息

Grupo de Micobacterias, Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C, Colombia.

Departamento de Patología, Facultad de Medicina, Universidad Nacional de Colombia.

出版信息

Biomedica. 2014 Jan-Mar;34(1):15-20. doi: 10.1590/S0120-41572014000100004.

Abstract

Primary laryngeal tuberculosis is a rare disease with a wide variety of clinical manifestations. We report the case of an ear-nose and throat diabetic physician with primary laryngeal tuberculosis. The diagnosis of laryngeal cancer had been considered before in another institution, and at the patient's admission, he only presented dysphonia with a six-month evolution. The vocal cord histological examination showed granulomas, giant cells, fibrosis and necrosis, and the Ziehl-Neelsen staining showed acid-alcohol resistant bacilli. The culture from vocal cord tissue was positive for mycobacteria, and IS 6110 -PCR was positive too. The Mycobacterium tuberculosis strain was sensitive to first line drugs. Treatment using directly observed therapy short-course (DOTS) was initiated. Clinical presentation, differential diagnosis, diagnostic workup, associated risk factors and a brief literature revision are discussed in this article.

摘要

原发性喉结核是一种罕见疾病,临床表现多种多样。我们报告了一例患有原发性喉结核的耳鼻喉科糖尿病医生的病例。之前在另一家机构曾考虑过喉癌的诊断,患者入院时仅表现为声音嘶哑,病程已有六个月。声带组织学检查显示有肉芽肿、巨细胞、纤维化和坏死,萋-尼氏染色显示抗酸杆菌。声带组织培养结核分枝杆菌呈阳性,IS 6110-PCR也呈阳性。结核分枝杆菌菌株对一线药物敏感。开始采用直接观察短程疗法(DOTS)进行治疗。本文讨论了临床表现、鉴别诊断、诊断检查、相关危险因素及简要文献复习。

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