The Journal of Laryngology & Otology

Clinical Records

Primary nasopharyngeal tuberculosis mimicking exacerbation of chronic rhinosinusitis

R Prstačića1 c1, M Jurlinaa1, M Žižić-Mitrečića1 and S Janjanina1

a1 University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Croatia

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.

(Accepted August 20 2010)

(Online publication April 12 2011)

Correspondence:

c1 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

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

Dr R Prstačić takes responsibility for the integrity of the content of the paper

Competing interests: None declared

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