Erstdiagnose einer Tuberkulose im HNO-Bereich

Zusammenfassung

Hintergrund:

Die Inzidenz von Tuberkuloseneuerkrankungen ist deutschlandweit rückläufig. Hauptmanifestationsort der Erkrankung ist die Lunge, in selteneren Fällen kann der Kopf-Hals-Bereich betroffen sein.

Material und Methoden:

Retrospektiv wurden am HNO Universitätsklinikum Bonn im Zeitraum zwischen 1997 und 2010 alle Patienten mit Erstdiagnose einer Tuberkulose im Kopf-Hals-Bereich ausgewertet.

Ergebnisse:

Es wurden 38 Patienten (24 weiblich, 14 männlich, Altersmedian 43,5±19,7 Jahre) erfasst. In über 60%  der Fälle waren die Patienten ausländische Staatsbürger. Hauptsächlich betroffen waren die zervikalen Lymphknoten (87% ), seltener kam es zu extranodulären Manifestationen mit organspezifischen Beschwerden (Sinus maxillaris, Cavum tympani, Larynx, Tonsillen). In nur 3 Fällen wurde präoperativ der explizite Verdacht auf eine Tuberkulose gestellt.

Schlussfolgerung:

Nur die Kenntnis der unterschiedlichen Manifestationsorte sowie eine genaue Infektionsanamnese können zur präoperativen Verdachsdiagnose einer mykobakteriellen Erkrankung führen.

Abstract

Initial Diagnosis of Head and Neck Tuberculosis

Background:

In Germany tuberculosis has a decreasing incidence. The lung is the most common focus, whereas head and neck manifestation occurs rarely.

Material and Methods:

Between 1997 and 2010 all patients with initial diagnosis of tuberculosis of the head and neck region were retrospectively reviewed at the University Hospital of Bonn, Germany.

Results:

38 patients (24 female, 14 male, median age 43.5±19.7 years) were analysed. More than 60%  were of foreign nationality. The majority of patients (87% ) presented with an unspecific cervical lymph node swelling. Extranodular manifestations (maxillary sinus, middle ear, larynx, tonsil) leading to organ specific symptoms rarely occurred. In only 3 cases a mycobacterial infection was suspected before surgery.

Conclusions:

Only the knowledge of different manifestation patterns as well as an accurate anamnesis of infectious diseases can lead to the tentative diagnosis of tuberculosis prior to surgery.

Autorenschaft: Es liegt eine geteilte Erstautorenschaft der Autoren A. Schröck und F. Göke vor.

Schlüsselwörter

Tuberkulose - HNO - Lymphknoten - Larynx - Inzidenz

Key words

tuberculosis - otorhinolaryngology - larynx - lymph-nodes

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