Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (4): 105-110.doi: 10.6040/j.issn.1673-3770.0.2022.530

Previous Articles    

Misdiagnosis of primary nasopharyngeal tuberculosis: a case report and literature review

LI Guangjin1,2,3, WANG Yan2,3, LIU Feifei2,3, SONG Xicheng2,3, SUN Yan2,3   

  1. 1. School of Clinical Medicine, Weifang Medical University, Weifang 261000, Shandong, China2. Department of Otorhinolaryngology Head and Neck Surgery, Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong, China;
    3. Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
  • Published:2023-07-27

PDF (PC)

100

Abstract: Objective This study aimed to provide a clinical reference for otolaryngologists by identifying the clinical characteristics of nasopharyngeal tuberculosis and causes of misdiagnosis. Methods This retrospective analysis included data of one case of misdiagnosis of primary nasopharyngeal tuberculosis(PNT). We analyzed the clinical characteristics of the case and reasons why it was easily misdiagnosed, considering the relevant literature. Results The clinical manifestations of PNT were related to the degree of hyperplasia of the nasopharyngeal lesions, which usually do not have clinical tuberculosis-related manifestations and cannot easily be distinguished from chronic nasopharyngitis. In cases wherein tuberculosis diagnosis is not clear enough based on pathological examination, tuberculosis-related tests should be performed and patients should be instructed to adhere to close follow-up. Regarding treatment, systemic anti-tuberculosis agents are still the mainstay of therapy. Conclusion PNT is relatively rare and lacks typical clinical manifestations, making it be easily misdiagnosed. Histopathology combined with tuberculosis-related tests could help improve diagnosis of PNT. Furthermore, regularly close follow-up is also an important key factor in avoiding misdiagnosis.

Key words: Primary nasopharyngeal tuberculosis, Chronic nasopharyngitis, Misdiagnosis

CLC Number: 

  • R766.04
[1] Patil C, Kharat Patil R, Deshmukh P, et al. Primary tuberculosis of nasopharynx(adenoid)-a rare presentation[J]. Asian Pac J Trop Med, 2013, 6(3): 246-248. doi:10.1016/s1995-7645(13)60033-4
[2] Min HJ, Kim KS. Primary nasopharyngeal tuberculosis: a case report focused on nasopharyngoscopic features and CT findings[J]. Ear Nose Throat J, 2021, 100(10_suppl): 949S-952S. doi:10.1177/0145561320931951
[3] Darouassi Y, Aljalil A, Hanine A, et al. Nasopharyngeal tuberculosis: report of four cases and review of the literature[J]. Pan Afr Med J, 2019, 33: 150. doi:10.11604/pamj.2019.33.150.15892
[4] Penjor D, Pradhan B. Diagnostic dilemma in a patient with nasopharyngeal tuberculosis: a case report and literature review[J]. SAGE Open Med Case Rep, 2022, 10: 2050313X221131389. doi:10.1177/2050313X221131389
[5] Altuntas E, Durmus K, Müderris S, et al. Primary tuberculosis of the nasopharynx: a rare case and literature review[J]. Indian J Otol, 2012, 18(2): 88. doi:10.4103/0971-7749.100732
[6] Sawada N, Inokuchi G, Komatsu H, et al. Nasopharyngeal tuberculosis[J]. J Infect Chemother, 2013, 19(6): 1158-1160. doi:10.1007/s10156-013-0574-0
[7] Srivanitchapoom C, Sittitrai P. Nasopharyngeal tuberculosis: epidemiology, mechanism of infection, clinical manifestations, and management[J]. Int J Otolaryngol, 2016, 2016: 4817429. doi:10.1155/2016/4817429
[8] Ahmed S, Mustahsan SM, Jamil B, et al. Nasopharyngeal tuberculosis[J]. J Coll Physicians Surg Pak, 2022, 32(4): S39-S40. doi:10.29271/jcpsp.2022.Supp1.S39
[9] Srirompotong S, Yimtae K, Jintakanon D. Nasopharyngeal tuberculosis: manifestations between 1991 and 2000[J]. Otolaryngol Head Neck Surg, 2004, 131(5): 762-764. doi:10.1016/j.otohns.2004.02.052
[10] 卢春容, 房宏霞, 陆普选, 等. WHO 2021年全球结核病报告:全球与中国关键数据分析[J]. 新发传染病电子杂志, 2021, 6(4): 368-372. doi:10.19871/j.cnki.xfcrbzz.2021.04.023 LU Chunrong, FANG Hongxia, LU Puxuan, et al. The global tuberculosis report 2021: key data analysis for China and the global world[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(4): 368-372. doi:10.19871/j.cnki.xfcrbzz.2021.04.023
[11] 胡智敏, 王飞. 鼻咽结核15例误诊分析[J]. 疑难病杂志, 2013, 12(5): 397-398. doi:10.3969/j.issn.1671-6450.2013.05.035 HU Zhimin, WANG Fei. Misdiagnosis analysis of 15 cases of nasopharyngeal tuberculosis[J]. Chinese Journal of Difficult and Complicated Cases, 2013, 12(5): 397-398. doi:10.3969/j.issn.1671-6450.2013.05.035
[12] 丁滨, 陈晓红. 2004~2013年耳鼻咽喉疾病中国误诊大数据概要分析[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(15): 1195-1200. doi:10.13201/j.issn.1001-1781.2016.15.005 DING Bin, CHEN Xiaohong. The analysis of the misdiagnosis big data of the otolaryngology during 2004 to 2013 in China[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(15): 1195-1200. doi:10.13201/j.issn.1001-1781.2016.15.005
[13] Yang Y, Fang Y, Yang G. Nasopharyngeal tuberculosis: a case report[J]. Open Life Sci, 2022, 17(1): 973-977. doi:10.1515/biol-2022-0077
[14] 章景泰, 王丽霞, 张存全. 探讨肺结核患者愈后复发相关影响因素研究[J]. 世界最新医学信息文摘, 2015, 15(26): 100. doi:10.3969/j.issn.1671-3141.2015.26.081 ZHANG Jingtai, WANG Lixia, ZHANG Cunquan. To explore the related factors of recurrence of pulmonary tuberculosis patients after recovery[J]. World Latest Medicine Information, 2015, 15(26): 100. doi:10.3969/j.issn.1671-3141.2015.26.081
[15] 扈启迪, 李耀君. 喉结核18例临床分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 85-89. doi:10.6040/j.issn.1673-3770.0.2016.380 HU Qidi, LI Yaojun. Clinical analysis of 18 patients with laryngeal tuberculosis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(2): 85-89. doi:10.6040/j.issn.1673-3770.0.2016.380
[16] 白云丹, 李重, 刘鹤, 等. 鼻咽结核1例并文献复习[J]. 中国耳鼻咽喉颅底外科杂志, 2020, 26(6): 695-697. doi:10.11798/j.issn.1007-1520.202006020 BAI Yundan, LI Zhong, LIU He, et al. Nasopharyngeal tuberculosis: a case report and review of the literature[J]. Chinese Journal of Otorhinolaryngology-skull Base Surgery, 2020, 26(6): 695-697. doi:10.11798/j.issn.1007-1520.202006020
[17] Saud M, Lazim N, Kamaludin Z, et al. Nasopharyngeal tuberculosis mimicking recurrence nasopharyngeal carcinoma: a case report[J].J Pioneer Med Sci, 2020, 9(1):15-18.
[18] 谢慧芬, 邓泽义, 苗湘琬, 等. 鼻咽结核2例报告并文献复习[J]. 临床耳鼻咽喉头颈外科杂志, 2018, 32(8): 624-626. doi:10.13201/j.issn.1001-1781.2018.08.017 XIE Huifen, DENG Zeyi, MIAO Xiangwan, et al. Nasopharyngeal tuberculosis: report 2 cases and review of the literature[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2018, 32(8): 624-626. doi:10.13201/j.issn.1001-1781.2018.08.017
[19] LEE HA na, Jung SM, Cho SH, et al. Two cases of primary nasopharyngeal tuberculosis[J]. J Rhinol, 2022, 29(3): 167-171. doi:10.18787/jr.2022.00409
[20] King AD, Ahuja AT, Tse GM, et al. MR imaging features of nasopharyngeal tuberculosis: report of three cases and literature review[J]. AJNR Am J Neuroradiol, 2003, 24(2): 279-282.
[21] 游勇, 胡元明, 吕涵清, 等. 鼻咽结核的MRI诊断与鉴别诊断[J]. 新医学, 2016, 47(4): 273-276. doi:10.3969/j.issn.0253-9802.2016.04.016 YOU Yong, HU Yuanming, LYU Hanqing, et al. MRI diagnosis and differential diagnosis of nasopharyngeal tuberculosis[J]. Journal of New Medicine, 2016, 47(4): 273-276. doi:10.3969/j.issn.0253-9802.2016.04.016
[22] 侯瑞芳, 何春. 布地奈德经鼻雾化吸入治疗慢性鼻咽炎的疗效观察[J]. 临床医学研究与实践, 2016, 1(5): 33. doi:10.19347/j.cnki.2096-1413.2016.05.026 HOU Ruifang, HE Chun. Observation on the therapeutic effect of budesonide inhalation through nose in the treatment of chronic nasopharyngitis[J]. Clinical Research and Practice, 2016, 1(5): 33. doi:10.19347/j.cnki.2096-1413.2016.05.026
[23] Ziad T, Nouri H, Adny A, et al. Miliaire tuberculeuse aiguëdu pharynx ou maladie d'Isambert: à propos d'un cas[J]. Arch De Pédiatrie, 2013, 20(1): 41-43. doi:10.1016/j.arcped.2012.10.010
[24] Masterson L, Srouji I, Kent R, et al. Nasal tuberculosis: an update of current clinical and laboratory investigation[J]. J Laryngol Otol, 2011, 125(2): 210-213. doi:10.1017/S0022215110002136
[25] Darouassi Y, Chihani M, Elktaibi A, et al. Association of laryngeal and nasopharyngeal tuberculosis: a case report[J]. J Med Case Rep, 2015, 9(1): 2. doi:10.1186/1752-1947-9-2
[26] Waldron J, Van hasselt CA, Skinner DW, et al. Tuberculosis of the nasopharynx: clinicopathological features[J]. Clin Otolaryngol Allied Sci, 1992, 17(1): 57-59. doi:10.1111/j.1365-2273.1992.tb00989.x
[1] SHE Zhiqiang, LIU Jiyuan. Atypical foreign body in the paralaryngeal space: a case report and review of literature [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(3): 60-63.
[2] HUANG Yangzhou, FU Lihua, WU Qiaolian, HUANG Xia, LIN Jun, YE Qing. Misdiagnosis of nodular fasciitis of mastoid process: a case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 119-121.
[3] WANG Zhixiang, XUE Kai, WEI Ning, HAN Shuang, JIN Chunshun.. A case of recurrent laryngeal nerve schwannoma misdiagnosed as a thyroid tumor. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(6): 33-35.
[4] SUN Shasha, QIU Jie, ZANG Chuanshan, SUN Yan. Behcets disease misdiagnosed as acute epiglottitis: a report of two cases. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(5): 107-109.
[5] LI Qingming, WU Sien, HUANG Suhong, CAO Huotai, HUANG Suihua, YAO Tingting, LIU Qihong. Diagnosis and treatment of the third branchial cleft fistula: a clinical report of 6 cases and literature review. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 61-64.
[6] SUN Changzhi, LIU Wenlong, LI Yan, LUO Renzhong. Diagnosis and treatment of otitis media with effusion in children with bilateral sensorineural deafness. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2015, 29(4): 11-14.
[7] SUN Xiu-mei, ZHANG Qing-quan, DU Ji-liang. Reasons for misdiagnosis of styloid process syndrome in 114 cases [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(6): 4-6.
[8] LIU Zhe， HOU Yan-li， WANG Yan-ling. One case of titled disc syndrome misdiagnosed as optic atrophy [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2014, 28(1): 91-92.
[9] WANG Zhi-gang, L Rong-lin. Deep neek space infection, one cases were misdiagnosed as acute epiglottitis [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(3): 89-89.
[10] SUN Ying， DONG Chang-xia. Misdiagnosis analysis on 2 cases of adult advanced Coats disease [J]. J Otolaryngol Ophthalmol Shandong Univ, 2013, 27(3): 93-94.
[11] LIU Wen-tong, HE Li-yong. Left ear teratoma misdiagnosed as lipoma in 1 case [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(6): 93-93.
[12] CHENG Wei1, CHEN Jian-zhi2. Diagnosis, misdiagnosis and differential diagnosis of  primary malignant tumors of the tonsil [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(3): 61-62.
[13] YANG Hong-xia. isdiagnosis and mistreatment of 1 case in esophageal foreign bodies [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(3): 92-92.
[14] SONG Qi1, WANG Huan-yi2, QIN Xue-jiao1. Vogt-KoyanagiHarada disease misdiagnosed as central retinitis [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2012, 26(2): 7-8.
[15] SHENG Hong-shen,HUANG De-liang,HAN Dong-yi,WU Wen-ming,YANG Wei-yan . Misdiagnosis of glomus jugulare tumor [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 120-122 .
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd