گزارش یک مورد سل دیواره خلفی اوروفارنکس

Upper respiratory tract is a rare site of tuberculosis infection. (1.9% of all tuberculosis cases). There are a few reported cases of nasopharyngeal and palatine tonsil infection, but posterior oropharynx is extremely a rare entity. The patient of the present study was a 67-year-old woman who referred to Shohadaye Haftom-e-Tir Hospital with progressive dysphagia and odinophagia from which she was suffering for about two months before being admitted to the hospital. She also had a history of productive cough without hemoptisis, which was associated with fever, chill, night perspiration and weight loss. Clinical examination revealed an exudative pharynx and cervical lymphadenopathy. Her chest roetgenogram showed a diffused reticulonoduler pattern and hillar lymphadenopathy of lungs. A pharyngeal fiber-optic examination showed an ulcerative mass in the posterior oropharyngeal wall. Also biopsy was taken and a culture for mycobacterium was positive. According to positive sputum staining for acid fast bacillus(AFB), oropharyngeal lesions and chest X-ray a diagnosis of tuberculosis of oropharynx with miliary tuberculosis was made therefore, the patient underwent anti-tubercular treatment. She was discharged with markedly decreased symptoms, but one month later she died because of stopping her medications. Upper respiratory tracts are generally resistant to tuberculosis, however, repeated exposure to infected sputum may overwhelm this defense. Pharyngeal tuberculosis should be included in the differential diagnosis of pharyngeal lesions, especially in endemic regions. The most important differential diagnosis of these lesions are neoplasms of pharynx. In conclusion, biopsies are indispensable for diagnosis and DOT (Directly Observed Therapy) is highly recommended. Key Words: 1) Tuberculosis 2) Oropharynx 3) Pharynx