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非典型患者肺外结核以喉部肿物形式的不寻常表现

Unusual Presentation of Extrapulmonary Tuberculosis as Laryngeal Mass in an Atypical Patient.

作者信息

Agarwal Rohan Dipesh, Marino Mark David, Whalen Matthew Joseph, Walker Ronald J

机构信息

Department of Otolaryngology, Head and Neck Surgery, Saint Louis University School of Medicine, St Louis, Missouri, USA.

出版信息

Case Rep Med. 2024 Dec 13;2024:9912317. doi: 10.1155/carm/9912317. eCollection 2024.

Abstract

Spread of Mycobacterium tuberculosis (MTB) to the larynx is exceedingly rare and can be obscured by more common conditions such as laryngeal cancer or oropharyngeal candidiasis, complicating an accurate diagnosis. Risk factors for chronic laryngeal disease, such as smoking and toxin exposure, place TB infection comparatively lower for consideration on a physician's differential. However, identifying these lesions is crucial from a medical and public health perspective to prevent community spread. We report the case of a 60-year-old male who presented with dysphonia, pharyngitis, aphasia, and significant unintentional weight loss. X-rays demonstrated focal opacities in the upper lung lobes. Laryngoscope biopsy revealed caseating granulomas and a positive culture for MTB. Laryngeal TB presents as a suspicious throat mass with nonspecific symptoms and should be thoroughly investigated by clinicians.

摘要

结核分枝杆菌(MTB)传播至喉部极为罕见,且可能被喉癌或口咽念珠菌病等更常见的病症所掩盖,从而使准确诊断变得复杂。慢性喉部疾病的风险因素,如吸烟和接触毒素,使得在医生的鉴别诊断中,结核感染相对较少被考虑。然而,从医学和公共卫生角度来看,识别这些病变对于预防社区传播至关重要。我们报告一例60岁男性病例,该患者出现声音嘶哑、咽炎、失语及明显的非故意体重减轻。X线显示上肺叶有局灶性混浊。喉镜活检显示干酪样肉芽肿且MTB培养呈阳性。喉结核表现为伴有非特异性症状的可疑喉部肿物,临床医生应进行全面调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edc/11661869/4633c731048f/CRIM2024-9912317.001.jpg

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