Tuberculosis cases in otorhinolaryngology

Justina Saladytė1, Mantas Žemaitaitis1, Aurelija Vegienė2

1Lithuanian University of Health Sciences

2Lithuanian University of Health Sciences, Kaunas Clinics, Clinic of Ear, Nose and Throat Diseases 2

 Abstract 

Tuberculosis (TB) is an infectious disease responsible worldwide for high morbidity and mortality. This problem is particularly common in some regions of the world called endemic zones due to high morbidity. Lithuania is classified as a medium risk country. Most often, TB affects the lungs. For a long time this disease has been associated with this organ only, but in recent years there has been an increase in the cases of extra-pulmonary TB, including Head & Neck TB. Patients often complain of non-specific symptoms, and the objective evaluation is also not informative, so testing and differential diagnosis are required. The disease can also occur in several organ systems at the same time, which can significantly complicate the treatment and outcomes and prolong the recovery period. In the diagnosis of TB, it is importantant the collection of anamnesis, because we must find out all the risk factors, lifestyle, contact with the sick, reject the possibility of relapse.

Methods: a retrospective study was performed in the Kaunas Clinics Hospital of LUHS, analyzing head and neck TB cases in the years 2013-2017.For literature analysis, the PUBMED-EMBASE database has been searched and articles analyzed.

Results: 2013-2017 In Kaunas Clinics, 12 cases of TB in the head and neck were diagnosed:in 7 cases TB was found in the larynx and in 5 cases in cervical lymph nodes.Mean age was 62,4±17,9 (33;86), men: 54±16,7 (33;80) years, women: 74,2±12,9 (60;86)  years. The most common symptoms of laryngeal TB were hoarseness, painful swallowing and dry cough. The most common symptoms of TB cervical lymphadenitis were formation in neck and general weakness. In the literature review it was found that most of the cervical lymphadenitis in the head and neck area is diagnosed.

Discussion: In Lithuania, the most frequently diagnosed site for Head & Neck TB is in the larynx. Majority of patients have either active pulmonary TB concomitantly or a positive anamnesis for pulmonary TB. Although TB mortality is decreasing in the world, this problem remains quite important in Lithuania. This is especially important for a group of people with co-morbid illnesses.

Keywords: tuberkuliozė, gerklų tuberkuliozė, gerklų vėžys, galvos ir kaklo tuberkuliozė, kaklo limfadenitas;