Nasal mass as the only extrapulmonary compromise of M. Tuberculosis infection

Main Article Content

Jorge Hernan Pineda-Vélez
Maria Camila Salazar-Agudelo
Ana María Sanchez-Moreno
Sara Moreno-Bedoya
https://orcid.org/0000-0003-3459-0769

Abstract

Tuberculosis is still a global public health burden. Infection caused by the bacillus Mycobacterium tuberculosis (M. Tuberculosis) manifests mainly in the lungs. However, around 20 % of cases occur in other anatomical locations and only 2 % have upper respiratory tract involvement. We present the case of a 75-year-old female patient, who returned to the otorhinolaryngology service due to epistaxis and postillomous lesions in the nasal cavity with a finding of a nasal mass. After surgical resection of the lesion, microbiological confirmation of M. tuberculosis infection is achieved. Studies are performed to rule-out lung involvement, as well as other locations. After the initiation of tuberculosis treatment, complete resolution of the lesion and no recurrence of symptoms is documented. Extrapulmonary forms of M. tuberculosis infection, and especially those involving the head and neck region, require a high index of suspicion for their diagnosis. Diagnostic methods such as PCR testing and tissue cultures allow optimal initiation of medical management according to local epidemiology and patient conditions.

Keywords:
Mycobacterium tuberculosis, nasal bone, extrapulmonar tuberculosis

Article Details

Author Biographies

Maria Camila Salazar-Agudelo, Clínica CES

Médico General. Clínica CES, Medellín, Colombia.

Ana María Sanchez-Moreno, Clínica CES

Médica General. Universidad CES (Medellín, Colombia)

Sara Moreno-Bedoya, Clínica CES

Médico Epidemiólogo. Clínica CES, Medellín, Colombia.

References

Global tuberculosis report 2022 [Internet]. Disponible en: https://www.who.int/publicationsdetail-redirect/9789240061729

Méndez-Samperio P. Diagnosis of tuberculosis in HIV Co-infected individuals: Current status, challenges and opportunities for the future. Scand J Immunol. 2017;86(2):76-82.

Vásquez A, Chipana V. Tuberculosis extrapulmonar: breve revisión general y nuevas alternativas de diagnóstico. Rev Cs Farm Bioq. 2016;4(2):71-9.

Bruzgielewicz A, Rzepakowska A, Osuch-Wójcikewicz E, Niemczyk K, Chmielewski R. Tuberculosis of the head and neck —epidemiological and clinical presentation. Arch Med Sci AMS. 2014;10(6):1160-6.

Srivanitchapoom C, Sittitrai P. Nasopharyngeal tuberculosis: Epidemiology, mechanism of infection, clinical manifestations, and management. Int J Otolaryngol. 2016;2016:1-6.

Rajiv C. M, Joy S. M. Tuberculosis in otorhinolaryngology: Clinical presentation and diagnostic challenges. Int J Otolaryngol. 2011;2011(686894):1-4.

Nalini B, Vinayak S. Tuberculosis in ear, nose, and throat practice: Its presentation and diagnosis. Am J Otolaryngol. 2006;27(1):39-45.

Marvin-Huergo ME, López-Garza NS, Dávalos-Fuentes MS. Head and neck manifestations of tuberculosis. An Otorrinolaringol Mex. 2021;66(4):321-9.

Quinteros DR, López FV, Gutiérrez CD, Cardemil MF. Infecciones por micobacterias en otorrinolaringología: Revisión de la literatura. Rev Otorrinolaringol Cir Cabeza Cuello. 2016;76(1):111-20.

Menon K, Bem C, Gouldesbrough D, Strachan DR. A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK. J Laryngol Otol. 2007;121(4):362-8.

Peralta G. Tuberculosis de cabeza y cuello. Acta Otorrinolaringológica Española. 2009;60(1):59-66.

Arias MF, Herrera MT. Nuevos métodos para el diagnóstico de la tuberculosis. Rev Chil Enfermedades Respir. 2016;32(4):254-9.

Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore). 2005;84(6):350-62.

Furin J, Cox H, Pai M. Tuberculosis. Lancet. 2019;393(10181):1642-56.

AlMatar M, AlMandeal H, Var I, Kayar B, Köksal F. New drugs for the treatment of Mycobacterium tuberculosis infection. Biomed Pharmacother Biomedecine Pharmacother. 2017;91(1):546-58.

Kellerman RD. Conn’s current therapy 2020. 1 Ed. Elsevier; 2020.

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, et al. The CARE guidelines: Consensusbased clinical case report guideline development. J Clin Epidemiol. 2014;67(1):46-51. 18. Joanna Briggs Institute [Internet]. Critical Appraisal Tools. Disponible en: https://jbi.global/critical-appraisal-tools