OVERVIEW
OVERVIEW
Nasal tuberculosis is an infection of the nose with Mycobacterium tuberculosis (M. tuberculosis for short). There are primary and secondary forms of the disease. Primary forms may be airborne, caused by direct or indirect contact with the patient, while secondary forms are often caused by tuberculosis foci in the lungs or tuberculosis in other parts of the body.
Whether medical insurance
Yes
Department
Otorhinolaryngology, Head and Neck Surgery
Clinical symptoms
Early symptoms are often very mild and may include nasal congestion, dizziness, bloody nasal discharge, etc. In severe cases, it may result in perforation of the nasal septum and collapse of the nose.
Hazards
In severe cases, it may cause perforation of nasal septum and collapse of nasal wings.
Examination
Nasal examination, smear for antacid bacilli, cranial CT examination, TB culture and animal inoculation, etc.
Diagnosis
As the pathological manifestations are often atypical, antacid staining of biopsies or culture of Mycobacterium tuberculosis is needed to make a definite diagnosis.
Treatment principle
Systemic anti-tuberculosis drug therapy is the mainstay, supplemented by appropriate local therapy.
Curable
Most of the cases can be cured with sufficient amount and course of anti-tuberculosis treatment.
Dietary advice
Eat foods rich in vitamin C and B vitamins.
Causes
Epidemiology
Rare, mostly secondary.
Etiology
Primary cases may result from airborne, direct or indirect contact with the patient, while secondary cases are most often caused by tuberculosis lesions or tuberculosis elsewhere.
Routes of transmission
Airborne, caused by direct or indirect contact with patients or tuberculosis bacilli.
Symptoms and Diagnosis
Typical symptoms
Early symptoms are often very mild, and may only include itching, burning sensation, and a small amount of exudate in the anterior part of the nose. As the lesion develops, the secretion increases, and there may be blood in the nasal discharge, with different degrees of nasal congestion, rhinorrhea, and olfactory impairment. In severe cases, it may even cause perforation of the nasal septum and collapse of the nose.
Other symptoms
If the sinuses are invaded, there will be dizziness, headache and other manifestations of sinusitis. There may be eye discomfort, tearing, tinnitus, ear overflow and so on. In severe cases, there may be systemic symptoms such as emaciation and fever.
Diagnostic basis
The possibility of nasal tuberculosis should be considered based on what is seen on local examination, plus the presence of tuberculosis foci in other parts of the body, especially in the lungs. Antacid staining of secretions, bacterial culture or pathologic examination may help in the diagnosis.
Treatment
Treatment guidelines
Strengthen nutrition, apply anti-tuberculosis drugs systemically, and use anti-tuberculosis drugs to drip the nose locally.
Drug treatment
1. Anti-tuberculosis drugs should be applied systemically, and streptomycin, para-aminosalicylic acid and isoniazid can be used at the same time. 2. Topical anti-tuberculosis drugs can be used as nasal drops. 3.
Surgery
Simple curettage for limited granuloma.
Other treatments
Ulcers and bleeding areas can be treated with corrosives or electrocautery.
Prognosis
The general prognosis is good.
Nursing care
Daily care
1. Maintain good hygiene and clean habits, don’t pick and dig the nostrils at will to avoid bringing tuberculosis bacteria in, and pay attention to regular cleaning of the nasal cavity. 2. Patients suffering from infectious tuberculosis should isolate themselves consciously to avoid infecting their family members, friends and the social groups. 3.
Dietary management
1. Do not eat fruits with too much acidity, avoid spicy, fried and overheated food. 2. Generally do not restrict the intake of carbohydrates during the recovery period, but the intake of fat should not be too much. 3. Pay attention to the supplementation of vitamin C and B vitamin. 4.