Tuberkulosis tonsil dan nasofaring disertai limfadenopati servikal dan tuberkulosis milier

Abstract

Latar belakang: tuberkulosis pada saluran nafas atas sangat jarang dijumpai dan biasanya disertai dengan penyakit paru primer. Dengan kemajuan pengobatan tuberkulosis saat ini, infeksi mycobacterium pada tonsil dan nasofaring jarang dijumpai. Limfadenopati servikal merupakan simptom yang sering terjadi, dan seharusnya didiagnosis banding dengan suatu massa di kepala dan leher. Tujuan: untuk menambah pengetahuan dalam mendiagnosis dan menangani tuberkulosis tonsil dan nasofaring yang jarang dijumpai. Kasus: Seorang anak laki-laki 14 tahun dikonsulkan dengan masa dileher bilateral disertai disfagia, demam dan malaise selama satu bulan. Penatalaksanaan: Pasien awalnya kami diagnosis banding sebagai suatu massa di kepala leher. Setelah ditegakkan diagnosis sebagai tuberkulosis
tonsil dan nasofaring disertai limfadenopati servikal dan tuberkulosis milier, diberikan terapi dengan anti tuberkulosis dan diperoleh hasil yang baik. Kesimpulan: Tuberkulosis sebaiknya dimasukkan sebagai diagnosis banding suatu massa di kepala dan leher terutama jika gambaran klinis dan pencitraan yang dijumpai tidak khas, sementara itu biopsi dan gambaran mikrobiologi selalu harus dipertimbangkan. 

Kata kunci: tuberkulosis nasofaring, tonsil, millier, limfadenopati.

ABSTRACT
Background: Tuberculosis (TB) of the upper aerodigestive tract is rare and is usually
associated with primary pulmonary disease. With recent advances in medical treatment of tuberculosis, mycobacterial infection of the nasopharynx and tonsil becomes very rare. The most common presenting symptom is cervical lymphadenopathy, so TB should be considered in the differential diagnosis of soft tissue masses of the head and neck. Purpose: To remind Otolaryngologists about the diagnosis and management of nasopharyngeal and tonsillar tuberculosis, which become rare case nowadays. Case: A 14-year-old boy was consulted with bilateral neck masses, disphagia, fever and malaise for one month. Case Management: At first we made a differential diagnosis of soft tissue masses of the head and neck. After he was diagnosed as nasopharyngeal and tonsilar tuberculosis with cervical lymphadenopathy and millier tuberculosis, the patient was treated with anti tuberculosis medication and the result was  good. Conclusion: TB should be considered in the differential diagnosis of soft tissue masses of the head and neck, particularly when the imaging findings and clinical presentation are atypical, at which point appropriate biopsies and microbiologic studies should be conducted. 

Keyword : Nasopharyngeal tuberculosis, tonsilar tuberculosis, cervical lymphadenopathy, millier
tuberculosis