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Not All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mind

dc.contributor.authorPedro, Bárbara
dc.contributor.authorMeleiro, Marta
dc.contributor.authorMarinho, António
dc.date.accessioned2021-11-22T14:44:55Z
dc.date.available2021-11-22T14:44:55Z
dc.date.issued2020-02-19
dc.description.abstractMycobacterium tuberculosis affects the middle ear in rare cases and is a challenging diagnosis. In this case, we present a 57-year-old patient diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-negative granulomatosis with polyangiitis (GPA) following a biopsy result of nasal granulomas, who was immediately started on immunosuppressive treatment. Years later, she developed progressive hypoacusis. Magnetic resonance imaging (MRI) revealed an extensive mass in the tympanic cavity extending to the mastoid. A biopsy of the mass was positive for Mycobacterium tuberculosis. Immunosuppressants were weaned and the patient was started on anti-tuberculous therapy with resolution of the complaints and findings. Tuberculous infections are difficult to diagnose and frequently mimic other illnesses, but in our case, we believe that an indolent tuberculous process was present from the beginning and evolved under immunosuppressive therapy. Learning points: The differential diagnosis of rhinosinus granulomatous findings includes inflammatory and infectious diseases (for example, tuberculous infections), in addition to neoplasms, cocaine abuse and trauma. A comprehensive differential diagnosis list is essential to mitigate diagnostic errors, especially in patients where auto-immune studies are negative or there is any doubt in the diagnosis. Latent tuberculosis screening should be a concern for physicians treating patients with immunosuppressive therapy, especially in endemic countries.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPedro B, Meleiro M, Marinho A. Not All ENT Granulomas Are Wegener's - Keep Tuberculosis in Mind. Eur J Case Rep Intern Med. 2020;7(3):001469. doi:10.12890/2020_001469pt_PT
dc.identifier.doi10.12890/2020_001469pt_PT
dc.identifier.issn2284-2594
dc.identifier.urihttp://hdl.handle.net/10400.16/2597
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSMC Mediapt_PT
dc.relation.publisherversionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7083184/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectTuberculosispt_PT
dc.subjectbiopsypt_PT
dc.subjectimmunosuppressionpt_PT
dc.subjectmastoiditispt_PT
dc.titleNot All ENT Granulomas Are Wegener’s – Keep Tuberculosis in Mindpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceItalypt_PT
oaire.citation.issue3pt_PT
oaire.citation.titleEuropean Journal of Case Reports in Internal Medicinept_PT
oaire.citation.volume7pt_PT
person.familyNameMarinho
person.givenNameAntónio
person.identifier.ciencia-id071D-2A63-84A4
person.identifier.orcid0000-0002-3295-6723
person.identifier.scopus-author-id7004241740
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication4f283ec3-446f-4a55-8451-207d4c4fe994
relation.isAuthorOfPublication.latestForDiscovery4f283ec3-446f-4a55-8451-207d4c4fe994

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