Tuberculosis in otolaryngology – a 6-year retrospective analysis on an infectious disease that is becoming increasingly relevant in Germany

Introduction Globally, tuberculosis (TB) plays an important role. In Germany it has become relevant in recent years due to increasing migration and the fear of antibiotic resistance. In ENT, extrapulmonary TB usually manifests in the secondary stage.

Material and methods A retrospective data collection was performed from the electronic patient record about the period 01.01.2017 to 31.10.2022. All patients were included who presented to the University Hospital Ulm due to ENT symptoms of an already diagnosed TB or with symptoms of a yet unknown TB.

Results 24 patients were evaluated (m=41.7%; w=58.3%). The mean age was w=45.21 years; m=37.6 years. 70.8% presented with cervical structures, abscesses, fistulas or cervical lymphnodes with subsequent evidence of TB. In 64.7%, the diagnosis was based on surgical tissue sampling. M. tuberculosis was detected in 72.7%, and microciological culture of vital mycobacteria was successful in 54.5%. M. tuberculosis DNA was detected by PCR in 27.3%. M. bovis or africanum was present in n=1. 75% were sensitive to all common tuberculostatics. 16.7% had tuberculosis manifestation pharyngeally, parapharyngeally, or in the epiglottis region. 12.5% did not have active TB but had surditas secondary to TB or due to tuberculostatic therapy.

Discussion The head and neck region may be the only site of manifestation of TB. This includes a pharyngeal or laryngeal change. Nonspecific manifestation presents the greatest difficulty. In case of a risk constellation, the differential diagnosis of TB should be considered early, also for the protection of the staff.

Publication History

Article published online:
12 May 2023