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Clinical Study of Extrapulmonary Head and Neck Tuberculosis: A Single-Institute 10-year Experience

机译:肺外头颈结核的临床研究:单机构十年经验

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摘要

>Introduction Although the incidence of tuberculosis (TB) in Japan has been decreasing yearly, Japan remains ranked as an intermediate-burden country for TB. >Objective This study aims to investigate the current situation of head and neck extrapulmonary TB (EPTB) diagnosed in our department. >Methods We retrospectively reviewed the clinical records of 47 patients diagnosed with EPTB in the head and neck in our department between January 2005 and December 2014. The extracted data included sex and age distribution, development site, chief complaint, presence or absence of concomitant active pulmonary TB (PTB) or history of TB, tuberculin skin test (TST) results, interferon-gamma release assay (IGRA) results, and duration from the first visit to the final diagnosis of EPTB. >Results The subjects consisted of 20 men and 27 women, and age ranged from 6 to 84 years. The most common site was the cervical lymph nodes (30 patients), with the supraclavicular nodes being the most commonly affected (60%). Histopathological examination was performed on 28 patients. TST was positive in 9 out of 9 patients and the IGRA was positive in 18 out of 19 patients. We observed concomitant PTB in 15 out of the 47 patients. Mean duration from the first visit to the final diagnosis of EPTB was 56 days. >Conclusion The clinical symptoms of TB, especially those in the head and neck region, are varied. Otolaryngologists should be especially aware of the extrapulmonary manifestations of TB to ensure early diagnosis and treatment from the public health viewpoint.
机译:>简介尽管日本的结核病发病率逐年下降,但日本仍然是结核病的中等负担国家。 >目的本研究旨在调查在我科诊断出的头颈外肺结核(EPTB)的现状。 >方法我们回顾性回顾了2005年1月至2014年12月间我科47例头颈部确诊为EPTB的患者的临床记录。提取的数据包括性别和年龄分布,发育部位,主要主诉,是否伴有活动性肺结核(PTB)或结核病史,结核菌素皮肤试验(TST)结果,干扰素-γ释放测定(IGRA)结果以及从首次就诊到EPTB最终诊断的持续时间。 >结果受试者包括20名男性和27名女性,年龄从6岁到84岁不等。最常见的部位是颈淋巴结(30例),锁骨上淋巴结是最常见的部位(60%)。对28例患者进行了组织病理学检查。 9名患者中有9名患者的TST阳性,而19名患者中有18名IGRA阳性。我们在47位患者中的15位观察到了伴随的PTB。从首次访视到确诊为EPTB的平均持续时间为56天。 >结论结核病的临床症状,尤其是头颈部区域的症状有所不同。耳鼻喉科医生应特别注意结核病的肺外表现,以确保从公共卫生的角度及早诊断和治疗。

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