Tuberculosis is a disease which can be defeated if we are all determined. I am an ENT and Head Neck surgeon and the ENT and Head Neck region , diseases where TB is a concern are:
Neck
Tubercular lymphadenitis involving the cervical lymph nodes also known as cervical lymphadenitis.May involve the front of the neck (anterior triangle) or the back(post triangle).This is the commonest tubercular presentation in ENT region. Discharging sinus from the neck node/swelling which is nonhealing.USG Neck and an Antigravity FNAC(Fine Needle Aspiration Cytology) from the swelling will help in diagnosis.
Ear
Tubercular otitis media: Pale ear discharge,blood stained ear discharge with or without multiple perforation in the ear drum gives a strong indication of tubercular otitis media.In chronic otitis media the tubercular origin is suspected during surgery on finding multiple perforation and pale granulation tissue.In that case the tissues are sent for AFB staining ,culture sensitivity,CBNAAT and then after confirming diagnosis Anti tubercular drugs started.The chronic ear discharge may also have excessive hearing loss with or without facial nerve paralysis of varying grades.
Is Tuberculosis in the ear contagious?
In case someone has tubercular otitis media ,it’s usually accompanied by lung Tuberculosis which if sputum positive is definitely contagious.Since Mycobacterium tuberculosis is spread through the air unless they are airborne and inhaled ,spreading through ear discharge is not documented.
Throat
Tubercular laryngitis:May present with or without fever,progressive hoarseness,pain throat(odynophagia),difficulty swallowing (dysphagia).The vocal cord may show pale granulation or polyp.This is often associated with Pulmonary Tuberculosis or TB of the lung and is contagious.
Nose
Nasal discharge blood stained with nasal obstruction because of nasal polyp or sinusitis.
Oral Cavity
Nonhealing oral ulcer: Tuberculosis needs to be ruled out along with Diabetes,malignancy or HIV.Rolled out margins with well-defined bases
Head
Tubercular meningitis is a serious condition and is beyond the scope of this current blog post.TB involving the Central Nervous System needs urgent intervention to avoid morbidity and mortality.
All presentations may be accompanied by fever ,weightloss,generalized weakness.All the condition requires proper diagnosis, and treatment with Anti Tubercular drugs and may also require surgery .The good news is Anti tubercular drugs are available for free at all Government designated centre’s under RNTCP(Revised National Tuberculosis Control Programme).
Awareness is crucial in all cases for early diagnosis and treatment.
