Naso-Septal Tuberculosis Mimicking Dermoid in a 3-Year old Child

Document Type: Case Report

Authors

1 Department of Otorhinolaryngology, Head and Neck Surgery, Maulana Azad Medical College, Delhi, India.

2 Department of Pathology, Maulana Azad Medical College, Delhi, India.

Abstract

Introduction:
Tuberculosis is a communicable disease caused by mycobacterium tuberculosis that primarily affects the lungs. Primary tuberculosis of the nose in the pediatric age group is rare. The diagnosis of this common entity in the present case was challenging.
 
Case Report:
We report the case of a 3-year old girl who presented with a painless swelling over the dorsum of the nose for 7 months. Imaging revealed a mass lesion eroding nasal bones, septum and frontal bone with intracranial extension. Endoscopic examination showed a friable mass in the superior aspect of the nasal septum, extending intracranially. Histopathology confirmed the diagnosis of nasal tuberculosis, and the patient improved on category I anti-tubercular therapy.
 
Conclusion:
Midline nasal swelling in children needs to be differentiated from congenital nasal swelling. A high index of suspicion is required for correct diagnosis of a patient with nasal tuberculosis. Anti-tubercular therapy is the mainstay of treatment.

Keywords

Main Subjects


1. Bahadur S, Thakar A. Specific chronic infections. In: Gleeson M, Scott-Brown’s Otorhinolaryngology, Head & Neck Surgery.7th ed. London: Hodder Arnold; 2008. P 1458–60.

2. Butt AA. Nasal tuberculosis in the 20th century. Am J Med Sci1997;313(6):332–5.

3. Kim YM, Kim AY, Park YH, Kim DH, Rha KS. Eight cases of nasal tuberculosis. Otolaryngol Head Neck Surg 2007;137(3):500–4.

4. Batra K, Chaudhary N, Motwani G, Rai AK. An unusual case of primary nasal tuberculosis with epistaxis and epilepsy. Ear Nose Throat J 2002; 81(12):842–4.

5. Etuwewe OM, Raghavan U, Kurian M. Trauma, nasal obstruction, epistaxis—a rare presentation of tuberculosis in the UK. Arch Dis Child 2011; 96: A52.

6. Dixit R, Dave L. Primary nasal tuberculosis. Lung India 2008;25(2):102–3.

7. Özer M, Özsurekçi Y, Cengiz AB, Özçelik U, Yalçin E, Gököz O. Primary Nasal Tuberculosis in a 10-Year-Old Girl. Canadian J Inf Dis Med Micro 2016:57–60

8. Tampi PS, Joshi SV, Nerurkar R. A case of primary nasal tuberculosis. Bombay Hospital J 2009 Spl. Iss: 48–51.

9. Kameswaran M, Kumar RSA, Murali S, Raghunandan S, Krishnan PV. Primary Nasal Tuberculosis - a case report. Indian J Otolaryngol Head Neck Surg 2006;59(1):87–9.

10. Sethi AD, Sareen DA, Sabherwal AAK, Agarwal AK. Tubercular pansinusitis presenting as nasal polyp. Indian J Tuberc 2005;52:99–101.

11. Chawla RK, Yadav SPS, Raj B, Goyal H, Rao NV, Yadav J, Chawla K. Tubercular sinusitis – A forgotten entity. Indian J Tub1989;36(3):187–8.

12. Jha D, Deka RC, Sharma MC. Tuberculosis of the maxillary sinus manifesting as a facial ab­scess. Ear Nose Throat J 2002;81:102–4.

13. Thakur JS, Chauhan I, Mohindroo S, Sharma DR, Mohindroo NK. Primary nasal tuberculosis. Clin Rhinol 2011;4(1):39–41.

14. Wadhera R, Kumar A, Gulati SP, Arora S. Tubercular osteomyelitis of nasal bones: A rare entity. Indian J Tuberc 2004;51:47–8. 

15. Tse GM et al. Tuberculosis of the nasopharynx: a rare entity revisited. Laryngoscope 2003; 113(4): 737-40

16. Elluru RG, Wootten CT. Congenital malformations of the Nose. In: Flint PW et al. Cummings Otolaryngology Head and Neck Surgery.5th ed. Philadelphia: Elsevier; 2010. p. 2686–90.