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Primary nasopharyngeal tuberculosis mimicking exacerbation of chronic rhinosinusitis

Published online by Cambridge University Press:  12 April 2011

R Prstačić ,
M Jurlina ,
M Žižić-Mitrečić  and
S Janjanin
R Prstačić*
Affiliation:
University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Croatia
M Jurlina
Affiliation:
University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Croatia
M Žižić-Mitrečić
Affiliation:
University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Croatia
S Janjanin
Affiliation:
University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Croatia
*
Address for Correspondence: Dr Ratko Prstačić, University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Kišpatićeva 12, HR-10000 Zagreb, Croatia Fax: +385 (0)1 2367559 E-mail: ratko.prstacic@zg.t-com.hr
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Abstract

Objective:

Nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. We report a case of primary nasopharyngeal tuberculosis from a non-endemic area, which presented with symptoms resembling exacerbation of previously diagnosed chronic rhinosinusitis.

Case report:

A 48-year-old man presented with extreme postnasal drip and an unpleasant nasal odour. Endoscopic examination revealed irregular thickening of the left lateral and posterior wall of the nasopharynx, partially covered with crusts and necrotic tissue. Histopathological study showed typical giant cell epithelioid granulomas with caseous necrosis. Direct examination after Ziehl–Neelsen staining was positive for tuberculosis. After six months of antituberculous triple therapy, endoscopic examination revealed a completely normal nasopharynx.

Conclusion:

To our best knowledge, this is the first published report of primary nasopharyngeal tuberculosis in a patient previously diagnosed with chronic rhinosinusitis. The difficulties in obtaining a proper diagnosis in such a case are discussed.

Keywords

Paranasal SinusesTuberculosisDiagnosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 7 , July 2011 , pp. 747 - 749
Copyright
Copyright © JLO (1984) Limited 2011

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Footnotes

Presented as a poster at the First Meeting of the European Academy of Otirhinolaryngology, Head & Neck Surgery, 27–30 June 2009, Mannheim, Germany

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