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Year: 2012  Vol. 16   Num. Suppl. 1  - May
DOI: 10.7162/S1809-977720120S1PO-129
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LARYNGEAL TUBERCULOSIS IN HOSPITALIZED PATIENT FOR LIVER CIRRHOSIS BY LIVER CIRRHOSIS
TUBERCULOSE LARINGEA EM PACIENTE INTERNADO POR CIRROSE HEPÁTICA
Author(s):
Thaís Doria Barbosa, Ulisses José Ribeiro, João Paulo Barnewitz, Leonardo Radünz Vieira, Felipe Longo Delduque Teixeira, Larissa Claret de Lima
Abstract:

OBJECTIVE: To describe a case of laryngeal tuberculosis, the symptoms and the treatment adopted. Report: MAB, 55 year old male patient with liver cirrhosis with portal hypertension, esophageal varicose veins, alcoholic liver disease, hospitalized for control of pulmonary sepsis. Endoscopy shows a lesion in the posterior wall of oropharynx. Patient presented with hoarseness associated with cough, bilateral vesicular murmurs lower at right apex being asked in which X-ray revealed diffuse infiltrate was seen, opacification in the right apex and elevation of the diaphragm. This examination led to diagnosis of pulmonary tuberculosis and miliary tuberculosis. We then ordered cultures of body fluids and nasofibroscopy with signs suggestive of purulent sinusitis and pharyngitis, septal deviation and depressed-looking lesion in the larynx with subsequent swelling and secretion stuck. Inflammatory aspect of irregularities in the vocal folds. Laryngeal vestibule with approximation of the ventricular bands. Pyrazinamide was started (four capsules orally in the morning) after the use of Zosyn and vancomycin with improvement of pulmonary and laryngeal symptoms. CONCLUSION: Tuberculosis is the most frequent cause of laryngeal granulomatosis becoming a common condition in view of its association with HIV. The laryngeal tuberculosis is present in 37.5% of patients with pulmonary tuberculosis is almost all due to direct inoculation of bacilli that reach the upper airway resulting in pulmonary cavitations. The diagnosis is made by a high index of suspicion associated with culture of M. tuberculosis, or pathology, or chest x-ray or Mantoux test or the Polymerase Chain Reaction (PCR).

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