Primary laryngeal tuberculosis: a rare cause of chronic laryngitis

Nayana Bhuyan, Anup K. Das


Tuberculosis (TB) is not only a major public health problem of developing countries like India, since its incidence is increasing due to increasing immune-depressive states including HIV, malignancies and cytotoxic chemotherapy. Laryngeal TB occurs usually a secondary to associate with pulmonary disease, and primary form is very rare in immune-competent people. We report a 49‑years‑old non-smoker, non-diabetic, immunocompetent man presenting with chronic dry cough and hoarseness without any constitutional symptoms, family or contact history of TB. The chest X-ray was normal. Laryngoscopy showed congested larynx without any ulcer or mass and normal vocal cords. Biopsy from aryepiglottic fold was suggestive of TB, but caseation was absent. Diagnosed to be primary laryngeal TB, he responded well to anti-tubercular therapy. Primary laryngeal TB without pulmonary TB can mimick chronic laryngitis. Before anti-tubercular drug use, in the 1950’s, it was a common and frequently fatal disease but it’s clinical features, age group involved and prognosis has changed over the last few decades. It is more infectious than pulmonary form primarily due to delayed diagnosis. It can mimick a common condition like chronic laryngitis, although different macroscopic lesions are described. Diagnosis needs a high index of suspicion, confirmed by histological examination, as it still can occur occasionally in immunocompetent persons. Response to specific treatment is good after diagnosis.


Atypical tuberculosis, Laryngeal tuberculosis, Primary laryngeal tuberculosis

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Benwill JL, Sarria JC. Laryngeal tuberculosis in the United States of America: A forgotten disease. Scand J Infect Dis. 2014;46:241-9.

Gandhi S, Kulkarni S, Mishra P, Thekedar P. Tuberculosis of larynx revisited: A report on clinical characteristics in 10 cases. Indian J Otolaryngol Head Neck Surg. 2012;64(3):244-7.

Loehrl TA, Smith TL. Inflammatory and granulomatous lesions of the larynx and pharynx. Am J Med. 2001;111 Suppl 8A:113S-7.

Chen H, Thornley P. Laryngeal tuberculosis: A case of a non-healing laryngeal lesion. Australas Med J. 2012;5(3):175-7.

Nishiike S, Irifune M, Doi K, Sawada T, Kubo T. Laryngeal tuberculosis: A report of 15 cases. Ann Otol Rhinol Laryngol. 2002;111(10):916-8.

Ling L, Zhou SH, Wang SQ. Changing trends in the clinical features of laryngeal tuberculosis: A report of 19 cases. Int J Infect Dis. 2010;14:e230-5.

Fernandes L, Mesqnita A. Stridor presentation in laryngeal tuberculosis. Indian J Tuberc. 1997;44:93 4.

Lin CJ, Kang BH, Wang HW. Laryngeal tuberculosis masquerading as carcinoma. Eur Arch Otorhinolaryngol. 2002;259(10):521-3.

Smulders YE, De Bondt BJ, Lacko M, Hodge JA, Kross KW. Laryngeal tuberculosis presenting as a supraglottic carcinoma: A case report and review of the literature. J Med Case Rep. 2009;3:9288.

Wang CC, Lin CC, Wang CP, Liu SA, Jiang RS. Laryngeal tuberculosis: A review of 26 cases. Otolaryngol Head Neck Surg. 2007;137(4):582-8.

Harney M, Hone S, Timon C, Donnelly M. Laryngeal tuberculosis: An important diagnosis. J Laryngol Otol. 2000;114(11):878-80.

Shin JE, Nam SY, Yoo SJ, Kim SY. Changing trends in clinical manifestations of laryngeal tuberculosis. Laryngoscope. 2000;110(11):1950-3.

Lim JY, Kim KM, Choi EC, Kim YH, Kim HS, Choi HS. Current clinical propensity of laryngeal tuberculosis: Review of 60 cases. Eur Arch Otorhinolaryngol. 2006;263(9):838-42.

Thakur A, Coulter JB, Zutshi K, Pande HK, Sharma M, Banerjee A, et al. Laryngeal swabs for diagnosing tuberculosis. Ann Trop Paediatr. 1999;19(4):333-6.

Inoue T. Difference in transmissibility between bronchial and laryngeal tuberculosis – A retrospective epidemiological study of TB patients newly registered in recent 19 years in Aichi Prefecture, Japan. Kekkaku. 2006;81(6):419-24.