Tuberculosis of the nose: Diagnosis and treatment methods

Tuberculosis of the nose is a rare disease, often occurring secondary to pulmonary tuberculosis; in some cases, nasal tuberculosis is also considered a primary infection. When Koch bacteria (Mycobacterium Tuberculosis) are accidentally inhaled by us, they can penetrate the nasal mucosa, causing pathology in the nasal area. Lesions often spread to the wings of the nose and surrounding facial skin. 

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• 1. What is nasal tuberculosis?
• 2. Nose TB has 2 main types
• 3. Is it easy to diagnose the disease?
• 4. Treatment

1. What is nasal tuberculosis?

Although rare, nasal tuberculosis has similar symptoms to other common nasal diseases

Tuberculosis of the nose was first described by an Italian anatomist in 1761, when the autopsy of a young man found an ulcer on his nose.

It is difficult to accurately diagnose nasal tuberculosis by routine examination, because the signs and symptoms are not obvious. The common symptoms are: ulcerative lesions in the nasal cavity, nasal congestion, runny nose, nosebleeds , nasal crusting, recurrent nasal polyps and sores in the nose ...

Nosebleed is one of the symptoms of tuberculosis of the nose

For many people, their first action every morning when they wake up is to reach for a box of tissues to wipe their nose. Why do so many people have a stuffy nose while sleeping, even when they don't feel sick? Let's see the article: 8 ways to treat stuffy nose that you should know  to learn about this problem!

2. Nose TB has 2 main types

2.1 Nasal Lupus (or Lupus vulgaris)

Nasal lupus should not be confused with the autoimmune disease Systemic lupus erythematosus , which is a painful, tuberculous skin lesion with the appearance of nodules, most commonly on the face, around the nose, and eyelids , lips, cheeks, ears and neck. Lupus vulgaris is the most common tuberculosis skin infection. Lesions can eventually develop into skin ulcers if left untreated.

Characteristics: in the same place, we can encounter many different forms of lesions (infiltrates, ulcers, fibrosis...).

In the early stages of the disease, symptoms are poor. The patient is uncomfortable with stuffy nose and dry scabs on one side of the nose that lasts for months. There are grainy bumps in the nose, yellow scabs, and bleeding to the touch. The skin on the outside of the nose is usually red and thick. The patient does not feel pain and is often mistaken for nasal Eczema.

In the full-blown stage, the symptoms of stuffy nose, runny nose with blood or nosebleeds gradually increase.

At this time, when you come to the examination and Endoscopy, you will have the following pictures:

Red-pink granules in the septum, or rough, pink, soft, bleeding masses, located near the anterior nasal opening and obstructing breathing.

Besides, it is also possible to encounter stable lesions such as narrow scars of the nose, loss of alar alar, loss of nasal sub-pillars. Tuberculosis of the nose is not life-threatening but causes facial destruction and shrinking facial scarring. In addition, nasal Lupus scars can turn cancerous. 

When you go to the doctor and have a nasal endoscopy, you can detect the symptoms of tuberculous nose

2.2 Tuberculosis of the nose

This form of tuberculosis is relatively uncommon and is seen only in patients with peptic ulcerative tuberculosis. In the patient's nasal cavity, there are rough sores, uneven edges, or flecks of millet in both nostrils. The nose is always clogged with pus and sebum. Prognosis is poor because patients can die from lung damage.

3. Is it easy to diagnose the disease?

Because nasal tuberculosis has atypical symptoms, it is often easy to confuse it with many other diseases such as: Eczema (Eczema), Syphilis (papules), or common inflammatory diseases of the nose. Therefore, the definitive diagnosis must be based on the biopsy results of the lesion.

Syphilis – “Syphilis” is a sexually transmitted disease caused by the spirochete Treponema pallidum. It is considered a social disease. Signs of syphilis are many, so it is easy to be confused with other diseases.

Nasal syphilis is quite common, because the nose is the preferred site of activity for spirochetes of syphilis. Syphilis usually appears 3 to 4 years after contracting syphilis. A common lesion is gum. This injury can cause bone necrosis, cartilage necrosis and scarring of the nose. Let's better understand this disease with the article: Nasal syphilis: Is it dangerous?

4. Treatment

It is necessary to combine local and systemic treatment.

Local treatment : 10% silver nitrate solution on the ulcer or using ultraviolet light. For deep lesions, use a spatula or electrocoagulation to destroy the lesion.

Systemic treatment : Treatment according to anti-tuberculosis regimen and some health-enhancing drugs such as fish oil, vitamin D2...

Thus, although rare, tuberculosis of the nose is a dangerous disease, leaving many sequelae. From the suggestions of abnormal signs in the skin of the nose, bleeding and upper nasal congestion, the patient should see a doctor soon. Definitive diagnosis of the disease by means of tissue biopsy of the damaged tissue in the nose will be performed by the Otolaryngologists.

Finally, just like preventing tuberculosis (which is the most common tuberculosis in the community), we need to maintain personal hygiene and keep the surrounding environment clean, eat, and rest properly. and resistance-strengthening exercise.