CLINICAL PRIMARY MANIFESTATION OF TUBERCU LOSIS IN THE HEAD AND NECK REGION AS A CHANCE FINDING

Between 1988 and 1992 12 patients were seen who had findings leading s ubsequently to the diagnosis of tuberculosis. The average age was 50 w ith a range from 22 to 88 years. Women outnumbered the male by 10 to 2 cases. The number of German patients equalled that of foreign patient s. Tuberculosis was mainly localised in the cervical lymph nodes in 6 cases. One patient was seen with manifestation in each case at the pal ate, larynx, nasopharynx, cheek, parotis and middle ear. Diagnosis was made by histology alone six times, by evidence of acid-fast rods once and by both means in 5 cases. Preoperatively a malignant neoplasm was suspected in most patients, and neither CT nor ultrasound revealed a hint to tuberculosis. Tine-test was positive in all patients. Only in 3 patients was there an evidence of acid-fast rods in sputum and gastr ic juice. None of them suffered from AIDS. They were treated by combin ation of rifampicin, ethambutol, isoniazid and partially with pyrazina mide. No relapse was observed to date.