Tuberculose épilaryngée : considérations épidémiologiques, cliniques et sanitaires

N. Saroul , J.-F. Vellin , O. Baud , O. Nohra , J.-L. Kemeny , L. Gilain
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引用次数: 1

Abstract

Objective

To report a case of laryngeal tuberculosis and to consider tuberculosis management in ENT practice.

Material and methods

A 44-year-old man, a smoker with pulmonary sarcoidosis experienced dysphonia with dysphagia. Laryngeal fibroscopy revealed an ulcerated epiglottic lesion. Direct laryngoscopy was performed to detect carcinoma, laryngeal sarcoidosis or tuberculosis. The histologic study revealed granulomatosis with giant cells and caseous necrosis. Tissue culture identified Mycobacterium tuberculosis.

Results

Antituberculosis therapy decreased dysphonia and dysphagia. Isolated ulceration disappeared at three months. Pulmonary infiltration decreased in radiography. The discovery of this case of laryngeal tuberculosis instigated hospital and community tuberculosis surveillance.

Conclusion

The ENT specialist should be aware of laryngeal tuberculosis in suspicious lesions. Mandatory declaration of such cases can motivate setting up tuberculosis surveillance.

脱毛性结核病:流行病学、临床和卫生方面的考虑
目的报告1例喉部结核,探讨耳鼻喉科肺结核的治疗。材料与方法一例44岁男性吸烟伴肺结节病患者出现吞咽困难伴发音困难。喉部纤维镜显示会厌病变溃疡。直接喉镜检查癌、喉结节病或结核。组织学检查显示肉芽肿伴巨细胞和干酪样坏死。组织培养鉴定结核分枝杆菌。结果抗结核治疗可减轻呼吸困难和吞咽困难。3个月时孤立性溃疡消失。x线片示肺浸润减少。该病例的发现促使医院和社区开展结核病监测。结论耳鼻喉科医师应警惕可疑病变中的喉结核。对这类病例的强制申报可促使建立结核病监测。
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