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Primary tonsillar tuberculosis
  1. Swetha Sasikumar1,
  2. Irfan Ismail Ayub1,
  3. Senthil Kannan2,
  4. Rajendiran Swaminathan3
  1. 1Department of Pulmonary Medicine, Sri Ramachandra University, Chennai, Tamil Nadu, India
  2. 2Department of Otorhinolaryngology, Sri Ramachandra University, Chennai, Tamil Nadu, India
  3. 3Department of Pathology, Sri Ramachandra University, Chennai, Tamil Nadu, India
  1. Correspondence to Dr Irfan Ismail Ayub, iia{at}


Upper aerodigestive tract involvement with tuberculosis is relatively rare and may be seen in up to 2% of patients with pulmonary tuberculosis. Isolated tonsil involvement with tuberculosis is not commonly seen in clinical practice. We report a case of a 22-year-old postpartum mother who presented with odynophagia, fever, loss of weight and submandibular swelling of 3 months’ duration. Clinical examination revealed a submandibular node, and oropharyngeal examination revealed necrotic slough overlying an enlarged left tonsil. Fine-needle aspiration cytology of the node and histopathological examination of the left tonsillectomy specimen revealed necrotising epithelioid cell granulomas, and stain for acid-fast bacilli was positive in the latter. She was diagnosed with tonsillar tuberculosis and was started on antituberculous treatment following which she improved clinically. This case serves to demonstrate an uncommon presentation of primary tuberculosis and reminds us to consider tuberculosis also as a microbiological aetiology for tonsillitis.

  • Tb and other respiratory infections
  • mouth
  • otolaryngology / ent
  • tuberculosis
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  • Contributors SS, IIA and SK: patient care and manuscript preparation. RS: examination and reporting on pathology specimens and manuscript preparation.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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