Laryngeal Tuberculosis

Epidemiology

There is an increasing incidence of tuberculosis in the United States since 1986. This trend is attributed to the increased incidence of acquired immune deficiency syndrome. This increase involves both pulmonary and extrapulmonary disease but involvement of the larynx remains rare. Laryngeal tuberculosis is usually secondary to active pulmonary tuberculosis. In the past, laryngeal tuberculosis typically affected patients between the ages of 20 and 40. In recent times patients in the older age group are more commonly seen.

Clinical Findings

Patients may present with any of the following symptoms: fever, weight loss, neck pain, dysphagia, hoarseness, and voice weakness. Clinical examination may reveal laryngeal edema, ulcerations, and associated cervical lymphadenopathy. Lung signs such as consolidation or collapse may also be evident.

Pathology

Expectoration or the pooling of infected sputum brings infected material into contact with the larynx. Infection may subsequently spread via the lymphatics to the regional lymph nodes. Tuberculosis typically produces granulomas where Mycobacterium tuberculosis is scanty. In contrast, the acid-fast bacilli appear in abundance in patients with tuberculous abscesses.