隐匿性结核感染导致喉软骨萎缩1例

Laryngeal cartilage atrophy caused by the infection of occult tuberculosis: a case report

摘要:

目的 分析喉结核的临床特点及诊治要点。方法 回顾性分析上海交通大学医学院附属第九人民医院收治的1例隐匿性喉结核患者的临床资料，整理诊治经过，并结合相关文献复习。结果 患者以反复咽痛、声嘶起病，迁延10年，逐渐导致以会厌萎缩为特征的喉软骨病变。经完善检查排除肿瘤及自身免疫性相关疾病，符合结核感染特征，经抗结核治疗喉部黏膜病变逐渐消失。结论 喉结核临床表现缺乏特异性，首诊极易误诊为慢性喉炎或一般细菌感染。当临床上遇到以反复咽痛、声嘶为表现的年轻患者，喉镜检查见广泛的黏膜水肿、溃疡及息肉样增生，特别是伴有喉软骨萎缩的患者，需警惕隐匿性结核感染的可能。

Abstract:

Objective To analyze the clinical features and key points of laryngeal tuberculosis. Methods It was analyzed retrospectively for one case of occult laryngeal tuberculosis admitted to the Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine. The diagnosis and treatment were reviewed in combination with relevant literature. Results The Patient with recurrent sore throat and hoarseness for 10 years gradually lead to epiglottic atrophy characterized by laryngeal cartilage lesions. Tumor and autoimmune related diseases were excluded according to systematic examination, which was consistent with the characteristics of tuberculosis infection. After anti tuberculosis treatment, laryngeal mucosal lesions gradually disappeared. Conclusions The clinical manifestation of laryngeal tuberculosis is lack of specificity. It is easy to be misdiagnosed as chronic laryngitis or general bacterial infection. When young patients with recurrent sore throat and hoarseness, especially with laryngeal cartilage atrophy, the patients should be taken attention to the possibility of occult tuberculosis infection.