A Case of Primary Nasopharyngeal Tuberculosis

Tuberculosis infections encountered in otorhinolaryngological practice include tuberculous lymphadenitis, pharyngeal tuberculosis, and tuberculous otitis media. The majority of cases are cases of secondary tuberculosis, and primary cases are rarely reported. In particular, primary nasopharyngeal tuberculosis is an extremely rare disease, with only a few reported cases from Japan. We report the case of a 51-year-old female patient with a lesion in the right nasopharynx. The patient had suffered from a sore throat of unknown cause for a year and was referred to our hospital for further investigation. Fiberoptic nasal endoscopic examination revealed an elevated lesion with a white membrane in the right nasopharynx. Biopsy revealed nasopharyngeal tuberculosis. Imaging studies showed no lung lesions, and we made a diagnosis of primary nasopharyngeal tuberculosis. After multidrug antituberculosis therapy as used for pulmonary tuberculosis, the raised lesion with the white membrane disappeared. In addition, sputum culture was negative, and the patient was considered cured. Nasopharyngeal tuberculosis manifests with nonspecific symptoms such as cervical lymphadenopathy, otorrhea, and sore throat. There are also no characteristic local findings. Early diagnosis is important because delay in diagnosis can lead to spread of secondary infection. Therefore, nasopharyngeal tuberculosis should be included in the differential diagnosis of nasopharyngeal lesions.