Tuberculosis presenting as bilateral vocal fold palsy: case report and review of otolaryngological manifestations of tuberculosis

Rennie, Catherine; Pai, Irumee; Selvadurai, David

doi:10.1017/s002221511100185x

Cited by 7 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only extracranial lower cranial nerve involvement, especially of the vagus nerve, e.g. in mediastinal or pharyngeal tuberculosis presenting as unilateral or bilateral vocal cord palsy, has repeatedly been reported [ 15 – 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Since cranial nerve palsies are a common late sequel of tuberculous meningitis, poor response to anti-tuberculosis therapy has been described [ 19 ]. In contrast, case reports on mediastinal or pharyngeal tuberculosis resulting in vocal cord palsy describe adequate recovery after anti-tuberculous treatment [ 17 , 18 ]. This case report demonstrates that cranial nerve impairment in tuberculous meningitis, particularly of the basal cranial nerve, is not only diagnostic but also prognostically important.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral vocal cord palsy as complication of CNS tuberculosis

et al. 2023

View full text Add to dashboard Cite

Background Tuberculous meningitis, a rare but severe form of extrapulmonary tuberculosis, frequently affects cranial nerves. While nerves III, VI and VII are commonly involved, involvement of caudal cranial nerves is rarely described. Here, we report a rare case of bilateral vocal cord palsy secondary to caudal cranial nerve involvement in tuberculous meningoencephalitis, that occurred in Germany, a country with low tuberculosis incidence. Case presentation A 71-year-old woman was transferred for further treatment of hydrocephalus as a complication of presumed bacterial meningitis with unknown pathogen at that time. Because of decreased consciousness, intubation was performed and an empiric antibiotic therapy with ampicillin, ceftriaxone and acyclovir was initiated. Upon admission to our hospital, an external ventricular drainage was placed. Cerebrospinal fluid analysis revealed Mycobacterium tuberculosis as the causative pathogen, and antitubercular treatment was initiated. Extubation was possible one week after admission. Eleven days later, the patient developed inspiratory stridor that worsened within a few hours. Flexible endoscopic evaluation of swallowing (FEES) revealed new-onset bilateral vocal cord palsy as the cause of respiratory distress, which required re-intubation and tracheostomy. The bilateral vocal cord palsy persisted despite continued antitubercular therapy on the follow-up examination. Conclusion Considering the aetiology of infectious meningitis, cranial nerve palsies may be suggestive for tuberculous meningitis as underlying disease given their rarity in other bacterial forms of meningitis. Nevertheless, intracranial involvement of inferior cranial nerves is rare even in this specific entity, as only extracranial lesions of inferior cranial nerves have been reported in tuberculosis. With this report of a rare case of bilateral vocal cord palsy due to intracranial involvement of the vagal nerves, we emphasize the importance of timely initiation of treatment for tuberculous meningitis. This may help to prevent serious complications and associated poor outcome since the response to anti-tuberculosis therapy may be limited.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bilateral vocal cord palsy as complication of CNS tuberculosis

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Bilateral vocal fold immobility has also been associated with inflammatory conditions related to underlying infections and granulomatous diseases. There are reports of patients infected with polio, tuberculosis, cytomegalovirus, West Nile virus, and herpes simplex virus presenting with bilateral vocal fold immobility [27][28][29][30][31]. Although Guillain-Barré syndrome rarely affects laryngeal function, it has been associated with bilateral vocal fold immobility when laryngeal function is compromised [6,32].…”

Section: Introductionmentioning

confidence: 99%

A Review of Treatment of Bilateral Vocal Fold Movement Impairment

Dunya

Orb

Smith

et al. 2021

Curr Otorhinolaryngol Rep

View full text Add to dashboard Cite

Purpose of Review Bilateral vocal fold immobility is a challenging life-threatening problem involving multiple treatment options and nuanced clinical decision making. We aim to provide relevant background on the etiology, diagnosis, and management of bilateral vocal fold movement impairment (BVFMI). Recent Findings Over the last 20 years, the management of bilateral vocal fold immobility has advanced significantly with the addition of multiple endoscopic approaches as well as procedures with the goal of returning dynamic function to the larynx, among them: selective reinnervation. Chemodenervation has also demonstrated promising results as a temporizing procedure in appropriately selected patients with BVFMI. Summary Tracheostomy remains the mainstay of emergent treatment for airway obstruction secondary to bilateral vocal fold immobility. However, recent advances in endoscopic approaches allow for avoidance of tracheostomy in many patients. Developments in dynamic procedures with the aim of restoring laryngeal function allow for adequate airway management while maintaining voice quality and limiting aspiration risk.

show abstract

“…The main aetiology of Mycobacterium tuberculosis (MTB) infection can occur in anyone without distinction amongst sex, age or localisation ( Adaikkappan et al, 2012 , Akintola et al, 2013 , Sabran et al, 2016 ). In 1993, the World Health Organisation (WHO) declared TB as a public health emergency ( Abdallah and Ali, 2012 , Rennie et al, 2011 ). Even though TB is endemic in all countries worldwide, in developing countries, it is more likely to cause deaths than other infectious diseases ( Akintola et al, 2013 , Gan et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

A review of medicinal plant of Middle East and North Africa (MENA) region as source in tuberculosis drug discovery

Dehyab

Bakar

AlOmar

et al. 2020

Saudi Journal of Biological Sciences

View full text Add to dashboard Cite

Tuberculosis (TB) is a disease that affects one-third of the world’s population. Although currently available TB drugs have many side effects, such as nausea, headache and gastrointestinal discomfort, no new anti-TB drugs have been produced in the past 30 years. Therefore, the discovery of a new anti-TB agent with minimal or no side effects is urgently needed. Many previous works have reported the effects of medicinal plants against Mycobacterium tuberculosis (MTB). However, none have focused on medicinal plants from the Middle Eastern and North African (MENA) region. This review highlights the effects of medicinal plants from the MENA region on TB. Medicinal plants from the MENA region have been successfully used as traditional medicine and first aid against TB related problems. A total of 184 plants species representing 73 families were studied. Amongst these species, 93 species contained more active compounds with strong anti-MTB activity (crude extracts and/or bioactive compounds with activities of 0–100 µg/ml). The extract of Inula helenium, Khaya senegalensis, Premna odorata and Rosmarinus officinalis presented the strongest anti-MTB activity. In addition, Boswellia papyrifera (Del) Hochst olibanum, Eucalyptus camaldulensis Dehnh leaves (river red gum), Nigella sativa (black cumin) seeds and genus Cymbopogon exhibited anti-TB activity. The most potent bioactive compounds included alantolactone, octyl acetate, 1,8-cineole, thymoquinone, piperitone, α- verbenol, citral b and α-pinene. These compounds affect the permeability of microbial plasma membranes, thus kill the mycobacterium spp. As a conclusion, plant species collected from the MENA region are potential sources of novel drugs against TB.

show abstract

Tuberculosis presenting as bilateral vocal fold palsy: case report and review of otolaryngological manifestations of tuberculosis

Abstract: The incidence of tuberculosis in the UK is increasing, particularly in urban areas. The otolaryngologist may encounter a wide variety of presentations. Diagnosis requires a high index of clinical suspicion.

Cited by 7 publications

References 16 publications

Bilateral vocal cord palsy as complication of CNS tuberculosis

Bilateral vocal cord palsy as complication of CNS tuberculosis

A Review of Treatment of Bilateral Vocal Fold Movement Impairment

A review of medicinal plant of Middle East and North Africa (MENA) region as source in tuberculosis drug discovery

Contact Info

Product

Resources

About