1/76. Primary mycobacterial infection of the uvula. Tuberculosis, and non-tuberculous mycobacterial infections are becoming more common thus it is more likely that otolaryngologists will encounter these conditions. We describe an otherwise well patient, with symptoms and signs from chronic uvular inflammation, who proved to have a primary mycobacterial infection. This is an unique presentation in the literature and reminds clinicians of the need, where uncertainty exists in diagnosis, to consider mycobacterial infections. ( info) |
2/76. Parotid tuberculosis simulating malignancy. An interesting case of parotid tumour simulating malignancy is reported. The rarity of this lesion and the associated clinical and diagnostic problems are emphasized together with the relevant literature. ( info) |
| Mycobacterial disease is an unusual but important condition that should be considered in the differential diagnosis of a discrete parotid gland swelling or mass. The management of this condition involves exclusion of neoplastic disease and combined medical and surgical therapy. We present 5 cases of mycobacterial involvement of the parotid gland and discuss issues surrounding the diagnosis and treatment options. ( info) |
4/76. Tuberculosis of the tongue secondary to pulmonary tuberculosis. Both secondary and primary tuberculosis of the tongue and oral cavity are rare. A case of tuberculosis of the tongue secondary to pulmonary tuberculosis in a 41-yr-old male patient is described. The clinical manifestation, diagnosis and response to the antituberculosis treatment are considered. ( info) |
5/76. Tuberculous ulcer of the tongue as presenting feature of pulmonary tuberculosis and hiv infection. Tuberculosis (TB), once a lethal disease, has shown a decrease in incidence with improved public health measures and availability of antituberculous drugs. But with the advent of human immunodeficiency virus (hiv) infection and acquired immunodeficiency syndrome (AIDS), it has re-emerged alarmingly as an opportunistic infection in immunocompromised patients. Lungs are the most commonly affected organs and involvement of the oropharyngeal region in TB is very rare. Two cases of TB manifesting as ulcer of the tongue are reported here. Interestingly, both of these cases were reported within a span of six months and both of the patients were in their early thirties. A primary diagnosis of both pulmonary TB and hiv sero-positivity was made after the diagnosis of the oral TB ulcer. ( info) |
6/76. Tuberculous parotitis: a series of five cases diagnosed on fine needle aspiration cytology. parotid gland tuberculosis is still a rare entity and has mostly been diagnosed after parotidectomy. We present five cases which were diagnosed on fine needle aspiration cytology (FNAC) and managed medically avoiding surgical intervention. ( info) |
7/76. Oral tuberculosis. Although rare, doctors and dentists should be aware of the possible occurrence of oral lesions of tuberculosis and consider them in the differential diagnosis of suspicious oral ulcers. ( info) |
8/76. Tuberculous parotitis: report of 3 cases. Tuberculous parotitis, particularly the diffuse form, is rare. I describe here three patients with diffuse tuberculous parotitis, two of whom presented with unilateral parotid swelling while the third had swellings of both glands. All had discharging sinuses. In two of the patients, the parotitis was associated with active pulmonary tuberculosis. In the patient with bilateral parotitis, the disease seemed to be confined to the glands. The diagnosis of tuberculosis was confirmed by the finding of tubercle bacilli in the lesion or the sputum. They all responded well to standard antituberculous drugs. ( info) |
9/76. Management of non-tuberculous mycobacterial peri-sialadenitis in children: the Sheffield otolaryngology experience. Non-tuberculous mycobacterial infection (NTM) has been recognized as an important cause of infection in the head and neck in children since 1956. It is important to differentiate NTM from the more serious mycobacterium tuberculosis (TB) since the management differs significantly. The causative organisms of NTM infection are resistant to the most commonly used anti-tuberculous preparations, though they do show sensitivity to the newer antibiotics such as clarithromycin, ciprofloxacin and azithromycin. Between 1986 and 1997, 15 patients with NTM infection involving the major salivary glands were treated at the Sheffield Children's Hospital Department of otolaryngology. There were 11 girls and four boys. In all patients the onset of symptoms was between September and April. Resolution occurred in two patients without surgery. The remaining 13 underwent formal surgical exploration with excision of the mass, associated nodes and of the overlying skin if necessary. There were nine parotid explorations. There were no long-term facial nerve deficits as a result of surgery and no recurrence of the disease. Co-operation between the Paediatrician and the Otolaryngologist is important for effective management since NTM may also affect the lungs, soft tissues, bones and joints. diagnosis relies upon culture, histology, chest radiography, purified protein derivative (PPD) testing, clinical features and skin testing. The use of antibiotics such as azithromycin with ciprofloxacin may be justified while waiting for the results of investigations, especially with small, early lesions, as resolution is possible. In patients who have no history of exposure to TB, are not immunocompromised, have a normal chest radiograph and have a Mantoux test with < 15 mm diameter induration, the treatment should be surgical excision rather than prolonged antibiotic therapy. ( info) |
10/76. Primary tuberculosis of soft palate. Primary tuberculosis of upper respiratory tract including oral cavity is a rare disease. One such unusual case is reported. ( info) |