Clinical study of tuberculosis in the head and neck region—11 years’ experience and a review of the literature

Abstract

Tuberculosis (TB) is an infectious disease and major health concern. Head and neck tuberculosis (HNTB) is relatively rare, but can arise in many regions, including the lymph nodes, larynx, oral cavity and pharynx. We retrospectively reviewed the clinical records of 60 patients diagnosed with HNTB in our department between March 2005 and January 2016. A review and summary of previous HNTB articles published in PubMed since 1885 was also performed. The subjects consisted of 17 males and 43 females, and the average age of patients was 45 ± 14.67 years. The major clinical presentation was a lump or swelling, followed by an oral ulcer and skin fistula. The most common site of tuberculosis was in the cervical lymph node. Three patients also suffered from a malignant tumor in the head and neck region. A total of 980 papers involving 5881 patients were included in our literature review. The included subjects ranged in age from 15 months to 100 years with a male-to-female ratio of 1.5:1. The larynx (38.92%), cervical lymph nodes (38.28%) and oral cavity (9.92%) were the three most common development sites. 465 patients were positive according to a HIV test, and 40 patients had comorbidities with different types of tumors. Head and neck tuberculosis should always be considered during a differential diagnosis for lesions in the head and neck region. Early diagnosis and treatment can greatly enhance the therapeutic effect and patients’ quality of life.

Evidence of a fixed internal gene constellation in influenza A viruses isolated from wild birds in Argentina (2006–2016)

“…The N7 subtype phylogeny shows that sequences of those IAVs isolated in Argentina, all from silver teals, are unique and share no relationship with those obtained from wild bird isolates in Chile 20 or Peru 19 (SFig. 18 , red branches).…”

“…The phylogenetic analysis of the internal gene segments from the Argentinean IAVs showed shared ancestry with equine-origin IAVs (PA, NP, NS-A), and avian-origin IAVs of Eurasia (PB2), North America (PB1, M, NS-B) and Antarctica (PA, M), demonstrating that their genetic diversity has been shaped by multiple introductions and reassortment occurring as early as the end of the 19th century 15 . Interestingly, the IAVs isolated from wild birds in Argentina have all internal gene segments of SAm origin, while many Chilean and Peruvian viruses have either all or most of their internal genes segments of NAm origin, and close to those from Central America 19 , 20 , 46 . More recently, H5N5 isolates from Antarctica were shown to carry gene constellations of NAm origin 7 , 18 , 47 .…”

Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis

“…Ultrasound images in the present study showed that edge-blurring, mixed echo or hyperechoic and calcified lesions are consistent with a diagnosis of lymph node tuberculosis. The necrotic lymph nodes are characterized by relatively sharp edges, low echo and no calcification [18]. Therefore, ultrasound imaging is helpful for a differential diagnosis of the two diseases.…”

Oral tuberculosis

“…It is estimated that 10% of cases of extrapulmonary TB are found in the head and neck region and 10% of those cases present in the oral cavity. 1,2 Early differentiation together with prompt multidisciplinary management prevents spread of this deadly disease.…”