Lao khẩu hầu: nhân một trường hợp

Phan Vương Khắc Thái, Nguyễn Thị Phương Loan, Nguyễn Thị Mộng Trinh, Nguyễn Tuấn Tài, Nguyễn Đình Thắng,  Lê Đình Thông,  Nguyễn Đình Duy, Nguyễn Huy Dũng, và cs *

Oropharyngeal tuberculosis, which is usually secondary to pulmonary tuberculosis (TB), is a rare manifestation. We report a case of oropharyngeal tuberculosis in an old man at the Tuberculosis Department for Men (A4) at Pham Ngoc Thach Hospital.
A 62-year-old male patient, who was transferred from Ho Chi Minh City Oncology Hospital with diagnosis of oropharyngeal tuberculosis by biopsy, presented to the Tuberculosis Department (A4) with the chief complaints of sore throat, loss of appetite, odynophagia and malaise. He was unable to swallow both liquid and solid food and had lost 10 kg of body weight within the last two months. Right cervical lymph nodes were detected. Oral and oropharyngeal examination showed that the posterior oropharyngeal wall mucosa was hyperemic and covered with multiple large, gray-white plaques of varying sizes. Chest radiograph showed ill-defined and irregular opacity in right lung and infiltrates at basal and axillary zones in left lung. Blood tests were within normal limits and HIV testing was negative. Sputum for acid fast bacilli (AFB) was positive and biopsy of lymph node showed images suggestive of tuberculosis. The patient was started on anti-TB treatment drugs (2SRHZE/1RHZE/5R3H3E3) together with antibiotics, symptomatic management and blood transfusion. After nearly 1 month of treatment, he recovered from symptoms and had normal appearing oropharyngeal mucosa. He was transferred to local TB unit for continuing treatment and follow-up.
The possibility of tuberculosis should be keep in mind, especially in developing countries where the incidence of tuberculosis is high. If ulcer lesions in the oropharynx or oral cavity does not respond to antibiotics, biopsy should be performed to confirm diagnosis.

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