Paulauskienė Iveta, Mickevičienė Vaiva
TChildren's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Paediatric otolaryngology departament; Santariskiu g. 7, Vilnius 08406, Lithuania.
Open Med (Wars). 2016 Mar 26;11(1):63-67. doi: 10.1515/med-2016-0013. eCollection 2016.
Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. 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. Rarely systemic diseases as amyloidosis, sarcoidosis, Wegener's granulomatosis or tuberculosis can cause vocal dysfunction too. That is why laryngeal tuberculosis is often forgotten in case of persistent hoarseness. In this article, we present a case of a young previously healthy woman, complaining of persistent hoarseness with no other leading symptoms. Though endoscopic image suggested a malignancy, histology showed granulomatous lesion. Detailed examination revealed laryngeal and pulmonary tuberculosis resistant to rifampicin.
Dysphonia can be the only one symptom of laryngeal tuberculosis. The disease should be taken into consideration when a patient complains of persistent hoarseness in order to avoid delays in treatment and spread of infection.
结核病仍然是最常见的肉芽肿性喉部疾病。缺乏特异性症状以及临床症状的变化常常导致误诊和治疗延误。声音嘶哑是喉结核最常见的症状，全身症状通常少见。然而，声音障碍可由许多其他更常见的疾病引起。声音嘶哑可能是器质性（声带结节和息肉、肿瘤、声带麻痹）或功能性（功能性发声障碍、喉转换障碍、矛盾性声带运动）疾病的症状。罕见的全身性疾病如淀粉样变性、结节病、韦格纳肉芽肿或结核病也可导致发声功能障碍。这就是为什么在持续性声音嘶哑的情况下，喉结核常常被漏诊。在本文中，我们报告了一例既往健康的年轻女性病例，她主诉持续性声音嘶哑，无其他主要症状。尽管内镜检查图像提示恶性肿瘤，但组织学检查显示为肉芽肿性病变。详细检查发现该患者患有耐利福平的喉结核和肺结核。
声音障碍可能是喉结核的唯一症状。当患者主诉持续性声音嘶哑时，应考虑到该病，以避免治疗延误和感染传播。
