A rare association of tonsillar tuberculosis and lichen scrofulosorum

Abstract Background Both tonsillar tuberculosis and lichen scrofulosorum are sporadic presentations of extrapulmonary tuberculosis. Lichen scrofulosorum commonly presents in children and young adults as lichenoid eruptions over the skin. Granulomatous inflammation of the tonsils, however, presents a...

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Main Authors: Anshika Harit, Anjan Kumar Sahoo, Ishwar Singh
Format: Article
Language:English
Published: SpringerOpen 2021-02-01
Series:The Egyptian Journal of Otolaryngology
Subjects:
Online Access:https://doi.org/10.1186/s43163-021-00083-z
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author Anshika Harit
Anjan Kumar Sahoo
Ishwar Singh
author_facet Anshika Harit
Anjan Kumar Sahoo
Ishwar Singh
author_sort Anshika Harit
collection DOAJ
description Abstract Background Both tonsillar tuberculosis and lichen scrofulosorum are sporadic presentations of extrapulmonary tuberculosis. Lichen scrofulosorum commonly presents in children and young adults as lichenoid eruptions over the skin. Granulomatous inflammation of the tonsils, however, presents as non-specific sore throat and foreign body sensation in the throat. The concomitant presentation of the abovementioned tubercular manifestations has not been reported in the literature. Case presentation Herein, we report a case of an 11-year-old male patient who presented with a history of recurrent sore throat and ulcerative lesion over the tonsil. Systemic examination revealed multiple perifollicular eruptions over the trunk and back. The diagnosis was confirmed on histopathological findings of epithelioid cell granulomas with Langerhans giant cells following biopsy from the tonsil and skin lesions. Antitubercular therapy was initiated soon after. The patient responded to treatment as early as 6 weeks and was completely asymptomatic at 1 year of follow-up. Conclusion A diagnosis of granulomatous tonsillitis should alert the physician to the possibility of underlying systemic tuberculosis. In our case, coexistence of lichen scrofulosorum helped us to substantiate the diagnosis based on the biopsy report. Response to antitubercular agents is excellent and should be started at the earliest.
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spelling doaj.art-cdd748ff184245a0bc41641d83ab1f3c2024-04-17T00:43:03ZengSpringerOpenThe Egyptian Journal of Otolaryngology1012-55742090-85392021-02-013711410.1186/s43163-021-00083-zA rare association of tonsillar tuberculosis and lichen scrofulosorumAnshika Harit0Anjan Kumar Sahoo1Ishwar Singh2Department of ENT, Dr. Baba Saheb Ambedkar Medical College and HospitalDepartment of ENT, Maulana Azad Medical College & Lok Nayak HospitalDepartment of ENT, Maulana Azad Medical College & Lok Nayak HospitalAbstract Background Both tonsillar tuberculosis and lichen scrofulosorum are sporadic presentations of extrapulmonary tuberculosis. Lichen scrofulosorum commonly presents in children and young adults as lichenoid eruptions over the skin. Granulomatous inflammation of the tonsils, however, presents as non-specific sore throat and foreign body sensation in the throat. The concomitant presentation of the abovementioned tubercular manifestations has not been reported in the literature. Case presentation Herein, we report a case of an 11-year-old male patient who presented with a history of recurrent sore throat and ulcerative lesion over the tonsil. Systemic examination revealed multiple perifollicular eruptions over the trunk and back. The diagnosis was confirmed on histopathological findings of epithelioid cell granulomas with Langerhans giant cells following biopsy from the tonsil and skin lesions. Antitubercular therapy was initiated soon after. The patient responded to treatment as early as 6 weeks and was completely asymptomatic at 1 year of follow-up. Conclusion A diagnosis of granulomatous tonsillitis should alert the physician to the possibility of underlying systemic tuberculosis. In our case, coexistence of lichen scrofulosorum helped us to substantiate the diagnosis based on the biopsy report. Response to antitubercular agents is excellent and should be started at the earliest.https://doi.org/10.1186/s43163-021-00083-zTuberculosis, CutaneousPalatine tonsilAntitubercular agentsDiagnosis, Differential
spellingShingle Anshika Harit
Anjan Kumar Sahoo
Ishwar Singh
A rare association of tonsillar tuberculosis and lichen scrofulosorum
The Egyptian Journal of Otolaryngology
Tuberculosis, Cutaneous
Palatine tonsil
Antitubercular agents
Diagnosis, Differential
title A rare association of tonsillar tuberculosis and lichen scrofulosorum
title_full A rare association of tonsillar tuberculosis and lichen scrofulosorum
title_fullStr A rare association of tonsillar tuberculosis and lichen scrofulosorum
title_full_unstemmed A rare association of tonsillar tuberculosis and lichen scrofulosorum
title_short A rare association of tonsillar tuberculosis and lichen scrofulosorum
title_sort rare association of tonsillar tuberculosis and lichen scrofulosorum
topic Tuberculosis, Cutaneous
Palatine tonsil
Antitubercular agents
Diagnosis, Differential
url https://doi.org/10.1186/s43163-021-00083-z
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