Tuberculosis of the tonsil: Case report and review

Cowan, D. L.; Jones, Graeme R.

doi:10.1016/0041-3879(72)90003-7

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…Tonsillar tuberculosis in humans has in the past been considered part of a primary complex caused by infection with M. bovis 29 , 30 . Consumption of raw contaminated cows’ milk has been thought to be the usual cause.…”

Section: Mycobacteria and Maltmentioning

confidence: 99%

“…In people with cervical lymphadenitis, the prevalence of confirmed tonsillar infection has been found to vary between 24 and 50%, 33 , 34 , 35 , 36 with the tonsillar infection usually asymptomatic 29 . In more recent times, following pasteurization of milk, M. tuberculosis rather than M. bovis has been more commonly isolated from the oropharyngeal tonsil 30 , 37 . Such isolates usually come from people showing signs of pulmonary involvement.…”

Section: Mycobacteria and Maltmentioning

confidence: 99%

“…Tonsillar tuberculosis in humans has in the past been considered part of a primary complex caused by infection with M. bovis. 29,30 Consumption of raw contaminated cows' milk has been thought to be the usual cause. Apart from tonsillar infection, concurrent lesions of the draining pharyngeal and cervical lymph nodes (peripheral lymphadenitis) are often present.…”

Section: Oropharyngeal Tonsilsmentioning

confidence: 99%

“…29 In more recent times, following pasteurization of milk, M. tuberculosis rather than M. bovis has been more commonly isolated from the oropharyngeal tonsil. 30,37 Such isolates usually come from people showing signs of pulmonary involvement. Only rarely has the tonsil been the site of the presenting lesion and in these cases the tonsil typically presents as a painful ulcer, sometimes also involving the lingual tonsils/epithelium.…”

Section: Oropharyngeal Tonsilsmentioning

confidence: 99%

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Mucosa‐associated lymphoid tissues as sites for uptake, carriage and excretion of tubercle bacilli and other pathogenic mycobacteria

Lugton

1999

Immunol Cell Biol

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Summary Pathogenic mycobacteria, including those that cause tuberculosis and paratuberculosis, cross mucosal barriers by endocytosis within mucosal lymphoepithelial sites. These entry sites commonly include oropharyngeal and nasopharyngeal tonsils and Peyer's patches. Bacilli discharged at the basolateral surfaces of engulfing epithelial M cells are taken up by professional antigen-presenting cells associated with T lymphocytes of the parafollicular area. Dendritic cells and macrophages in these sites allow mycobacterial replication, due to the permissive immunological environment in lymphoepithelial tissues. Abrogation of local delayed-type hypersensitivity reactions generally ensures continuing integrity and function of these tissues. Phagocytes containing intracellular mycobacteria disseminate infection to other parts of the body and also probably migrate back onto the mucosal surface to shed bacilli.

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Section: Mycobacteria and Maltmentioning

confidence: 99%

Section: Mycobacteria and Maltmentioning

confidence: 99%

Section: Oropharyngeal Tonsilsmentioning

confidence: 99%

Section: Oropharyngeal Tonsilsmentioning

confidence: 99%

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Mucosa‐associated lymphoid tissues as sites for uptake, carriage and excretion of tubercle bacilli and other pathogenic mycobacteria

Lugton

1999

Immunol Cell Biol

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“…The percentage of patients with concomitant pulmonary involvement was 41, [10,16,39–53] among them identifying 1 case of simultaneous pulmonary, tonsillar and cerebral tuberculosis, [54] 1 case of simultaneous pulmonary, tonsillar and renal involvement, [55] 3 cases of pulmonary, tonsillar and larynx tuberculosis, [56–58] and 5 immunocompromised patients: 1 case of HIV infection associated with pulmonary and tonsillar tuberculosis, [59] 2 patients developing pulmonary and tonsillar tuberculosis under anti TNF alpha inhibitors treatment, [60,61] and 2 cases of epithelial squamous cell carcinoma of the tonsil [62] or tongue [63] coexisting with pulmonary and tonsillar tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Primary tonsillar tuberculosis in a pediatric patient

Moisă¹,

Miron²,

Adam-Raileanu³

et al. 2021

Medicine

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Rationale:Tuberculosis is an entity that usually affects the lungs, although extrapulmonary sites can also be involved. Tonsils are rarely affected, especially in the absence of pulmonary disease, primary tonsillar tuberculosis being a diagnostic challenge for the clinician.Patient concerns:We present the case of a 14-year-old female teenager, presented to our Pediatric Service with a 14-day history of dysphagia, odynophagia and left reflex otalgia associated with a 5 kg weight loss. Clinical examination revealed mild pharyngeal erythema, marked enlargement of the left tonsil infiltrating the lateral pharyngeal wall and the uvula and painful, mobile, nonadherent to deep bilateral latero-cervical adenopathy.Diagnosis:Positive interferon-gamma release assay (QuantiFERON-TB gold). Mantoux test reading was 16 mm.Interventions:During hospitalization, the patient received Clindamycin and Gentamicin for 3 days i.v., with discrete relief of symptoms and inflammatory markers. On the 4th day of hospitalization, treatment with Imipenem/Cilastin is started for 7 days in micro-perfusion, with tonsil hypertrophy decrease in size and favorable clinical evolution.Outcome:Tonsil hypertrophy decreased in size and patient had a favorable clinical evolution. At discharge, the patient was given a 6-month course of anti-tuberculous drug.Lessons:The particularity of this case is represented by the rarity of primary tuberculosis of tonsils in children, with unilateral involvement, displaying at the same time a common issue encountered in the current practice: the limitations and the difficult course of setting the diagnosis due to the involvement of relatives in the medical act.

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