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耳鼻咽喉科结核病的一些表现——病例系列及东南欧相关数据的简短综述

Some Manifestations of Tuberculosis in Otorhinolaryngology - Case Series and a Short Review of Related Data from South-Eastern Europe.

作者信息

Mocanu Adela-Ioana, Mocanu Horia, Moldovan Cosmin, Soare Ioana, Niculet Elena, Tatu Alin Laurentiu, Vasile Claudiu Ionut, Diculencu Daniela, Postolache Paraschiva A, Nechifor Alexandru

机构信息

Department of ENT & HNS, Polimed Medical Center, Bucharest, Romania.

Department of ENT & HNS, Faculty of Medicine, "Titu Maiorescu" University, Bucharest, Romania.

出版信息

Infect Drug Resist. 2022 May 31;15:2753-2762. doi: 10.2147/IDR.S367885. eCollection 2022.

Abstract

Tuberculosis is a disease of global outreach that may affect the entire human body but is most commonly located in the lungs. Otorhinolaryngological manifestations of tuberculosis are rare, mostly occurring secondary to pulmonary disease but nevertheless represent significant diagnostic challenges. Nasopharyngeal tuberculosis is rare, representing around 1% of all upper air-way localizations and the most common presentation is in the form of adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. We present four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid occurrence of complications.

摘要

结核病是一种全球性疾病,可累及全身,但最常见于肺部。结核病的耳鼻咽喉科表现较为罕见,大多继发于肺部疾病,然而却构成了重大的诊断挑战。鼻咽部结核很罕见,约占所有上呼吸道局部病变的1%,最常见的表现形式为腺样体病变。结核性舌炎(口腔结核)更为少见,可呈现多种临床形式,通常类似恶性肿瘤,或较少见地类似创伤或其他感染性病变。口咽部结核通常被误诊为肥厚性慢性扁桃体炎。我们报告了4例耳鼻咽喉结核罕见病例,其中1例为13岁女孩的原发性腺样体炎和扁桃体炎,1例为65岁女性的结核性舌炎奇症,临床诊断为舌部肿瘤,还有2例为结核性淋巴结病,罕见地位于下颌下和锁骨上区域。病例报告之后是对文献的全面综述。耳鼻咽喉部位的结核表现仍然难以确诊,尤其是因其罕见性和非特异性临床表现,在咽部病变的鉴别诊断中应考虑到该病。早期诊断对于避免并发症的发生至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04dd/9166903/9600c99f8439/IDR-15-2753-g0001.jpg

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