4.2.10. Tuberculosis of upper respiratory tract (epiglottis, larynx, pharynx)


Tuberculosis of upper respiratory tract epiglottis, larynx, pharynx meet as complication of primary and secondary lung tuberculosis and of intrathoracic lymphatic nodes. Only sometimes these forms especially, the bronchi tuberculosis could be as isolated forms.

Three basic forms of bronchi and trachea tuberculosis are distinguished:

  1. infiltrative;
  2. ulcerative;
  3. fistulous (lymph-bronchial, bronchial-pleural fistulas).

Complications such as bronchi stenosis of a different degree, granulations, and bronchiolitis most often met. Under influence of treatment, clinical healing could be achieved without residual changes and with residual changes as scars, fibrotic thickenings, stenosis etc.

Tuberculosis of a mouth is rare.
It usually occurs in the gum. It shows as a relatively painless swelling, which is often ulcerated. As tuberculosis of the mouth is frequently a primary lesion there is often enlargement of the regional lymph nodes. Tuberculosis of the mouth and tonsil lesions, which are similar, are likely to be due to infected milk, or perhaps occasionally food, or infected droplets from the air. Lesions of tonsils may not have clinical signs. They are often ulcerated and may be very painful. They rapidly improve with chemotherapy. The tuberculosis of tongue can be secondary, at far advanced lung tuberculosis. The tubercular lesions of a tongue frequently ulcerated, can be very painful. They are successfully treated with chemotherapy.

Clinical signs of tuberculosis of upper respiratory tract.

  1. The patient may have had cough and sputum for some time as laryngeal disease occurs most often in advanced pulmonary tuberculosis. There may also be loss of weight and other intoxication symptoms.
  2. Hoarseness and changes in voice up to whispering at larynx tuberculosis.
  3. Pain in the ear.
  4. Pain on swallowing which usually means the epiglottis is also involved. Pain may be severe.
  5. In very advanced disease at the tongue may ulcers develop.
  6. Examination shows ulceration of the cords or other areas in the upper respiratory tract.
  7. Examination of the sputum reveals MBT.
  8. Chest X-ray reveals as a rule lung tuberculosis.

The tuberculosis of larynx begins with superficial laryngitis, then ulceration occurs and granulema formationoccur. An epiglottis Is defeated sometimes. Dysphonia – basic attribute of tubercular laryngitis.

Distinguishing it from other diseases.
The main disease to distinguish from tuberculosis is cancer. Malignant disease of the larynx is rarely painful. The sputum is usually positive but the diagnosis may need to prove by biopsy in difficult cases. If biopsy is not possible and but tuberculosis is very suspected, diagnostic chemotherapy could be recomended.

Tuberculosis of the larynx responds extremely well to chemotherapy. If there is severe pain, which does not quickly clear with treatment, add prednizolon for 2-3 weeks (if available), for quick resolution of u nspecific inflammatory changes.

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