Increasing relevance of extrapulmonary tuberculosis in the head and neck – 10 years of single center experience

Introduction Tuberculosis is one of the most frequent infectious diseases worldwide, with increasing incidence in western countries. Since extrapulmonary manifestations very often occur in the head and neck, it is an important differential diagnosis for ENT-specialists. The aim of the present study is to provide an overview on manifestations and diagnostics of tuberculosis in the head and neck and to highlight possible mistakes in the initial diagnosis.

Methods The data of 35 patients with extrapulmonary tuberculosis was analyzed retrospectively. Parameters investigated were localization, initial diagnosis, patient characteristics, radiologic findings, histopathologic and microbiological results and clinical course.

Results: In 40 %  tuberculosis was the initial diagnosis, a malignancy was suspected in 40 %  and an abscess in 20 % . Most frequent localizations were cervical lymph nodes (62 % ) and the larynx (8.5 % ). 60 %  of the patients were born in countries with a high prevalence of tuberculosis, and 28 %  had relatives with a positive history of tuberculosis. Open pulmonary tuberculosis was found in 31 % , while 37 %  had a medical history with an underlying immunosuppressive disease. In all cases, validation of tuberculosis could be accomplished with pcr or a microbiological culture. While often radiologically suspicious for an abscess, inflammation values were generally low. Wound healing disorders after surgical therapy occured in 26 % .

Conclusion Tuberculosis remains an increasingly relevant differential diagnosis for ENT specialists. An early diagnosis can help prevent infections for family members and medical staff. Especially a radiological suspicion of an abscess with low inflammations parameters should lead to a consideration of tuberculosis as a differential diagnosis.

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Publication History

Article published online:
13 May 2021