Primary Nasal Tuberculosis as the Origin of Submaxillary Adenopathy Tuberculosis nasal primaria como origen de adenopatía submaxilar

We present the case of a 75-year-old woman with a history of insulin-dependent diabetes mellitus, arterial hypertension, dyslipidemia and serious congestive heart failure. She consulted in the emergency department due to a tumour in the left submaxillary region which had developed over more than 4 months, with progressive growth and considered to be an adenophlegmon, treated with amoxicillin and clavulanic acid 875/125 mg during 2 weeks with no clinical improvement. Physical exploration found a tumour measuring 3 cm×4 cm in the left submaxillary region, indurate, not adhered to deep planes and without other alterations. Luekocytosis was observed in blood analysis (11 300×10e9/l) with segmented neutrofils (75.3%). Serologies were performed for HIV, VEB and hepatitis, and all were negative. CT of the neck was performed with contrast. This showed the left para-oropharyngeal neoformative process with multiples adenopathies in all of the cervical spaces, most especially a retropharyngeal one and the largest in the left