J Rhinol.  2022 Nov;29(3):167-171. 10.18787/jr.2022.00409.

Two Cases of Primary Nasopharyngeal Tuberculosis

• Lee HN
• Jung SM
• Cho SH
• Jeong JH

• KMID: 2536586
• DOI: http://doi.org/10.18787/jr.2022.00409

Abstract

Nasopharyngeal tuberculosis can arise from both a primary infection and a secondary spread via the lymphatic or hematogenous system from a primary pulmonary lesion. Primary nasopharyngeal tuberculosis is rare and difficult to detect earlier because of the nonspecific presentations of the disease. As upper airway tuberculosis can be contagious, early initial diagnosis and suspicion of the physicians are needed in clinical practice. Recently, we successfully diagnosed and treated the disease by antitubercular medications of two cases of primary nasopharyngeal tuberculosis. Herein, we report our experience with a literature review.

Keyword

Nasopharynx; Tuberculosis

Figure

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  Fig. 1. Initial nasopharynx endoscopic and CT findings of case 1. A: Endoscopic finding: melted cheese like necrotic tissue with purulent discharge on right posterior wall of nasopharynx. B: Neck CT: peripheral rim enhancing mucosal thickening of right posterior nasopharynx extended to Eustachian tube (arrow).

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  Fig. 2. Ziehl–Nielsen staining from biopsy specimen with acid-fast bacilli.

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  Fig. 3. Follow-up nasopharyngeal examination after 6 months of antitubercular treatment.

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  Fig. 4. Initial nasopharynx endoscopic and CT findings of case 2. A: Endoscopic finding: necrotic tissue like melted cheese with purulent discharge on posterior nasopharynx. B: Neck CT: mucosal thickening and increased enhancement of nasopharynx (arrow) with 0.9 cm lymph node in right retropharyngeal area (arrow head).

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  Fig. 5. Follow-up ear endoscopic and CT findings before antitubercular treatment. A: Endoscopic finding: tympanoscopic examination showed a right tympanic membrane perforation and otorrhea. B: Temporal CT: soft tissue density in right mastoid cavity and middle ear (circle).

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  Fig. 6. Follow-up endoscopic examination which was performed 5 months after antitubercular treatment started. A: Nasopharynx. B: Right tympanic membrane.

Reference

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