Different patterns of presentation of primary laryngeal tuberculosis

ABSTRACT

Primary laryngeal tuberculosis without lung involvement is rare. The cases reported in the literature have been isolated case reports or series of patients including both primary laryngeal tuberculosis and the form associated with pulmonary disease. Two cases of primary laryngeal tuberculosis are reported to demonstrate the variable presentation of the disease. One case presented with chronic dysphonia. The other case presented acutely with upper respiratory tract obstruction and systemic inflammatory response syndrome [SIRS], requiring urgent tracheostomy and systemic support. To the best of the author's knowledge, no previous report has been made of primary laryngeal tuberculosis presenting with SIRS. Both cases reported were middle-aged men who had no evidence of pulmonary tuberculosis after evaluation of the chest radiograph and sputum culture. Significant supraglottic oedema was seen in each patient on fibreoptic laryngoscopy. Tuberculous granulomas with no evidence of caseation were evident on the biopsy of the larynx. Laryngeal tuberculosis should be considered in the differential diagnosis of laryngeal inflammatory lesions seen by otolaryngologists