title: Primary nasopharyngeal tuberculosis mimicking exacerbation of chronic rhinosinusitis.
abstract: OBJECTIVE
  Nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. We report a case of primary nasopharyngeal tuberculosis from a non-endemic area, which presented with symptoms resembling exacerbation of previously diagnosed chronic rhinosinusitis.
  
  
  METHODS
  A 48-year-old man presented with extreme postnasal drip and an unpleasant nasal odour. Endoscopic examination revealed irregular thickening of the left lateral and posterior wall of the nasopharynx, partially covered with crusts and necrotic tissue. Histopathological study showed typical giant cell epithelioid granulomas with caseous necrosis. Direct examination after Ziehl-Neelsen staining was positive for tuberculosis. After six months of antituberculous triple therapy, endoscopic examination revealed a completely normal nasopharynx.
  
  
  CONCLUSIONS
  To our best knowledge, this is the first published report of primary nasopharyngeal tuberculosis in a patient previously diagnosed with chronic rhinosinusitis. The difficulties in obtaining a proper diagnosis in such a case are discussed.
authors.affiliation: University Department of ENT, Head and Neck Surgery, Zagreb University Hospital Center, Zagreb, Croatia. ratko.prstacic@zg.t-com.hr
authors.forename: R
authors.initials: R
authors.lastname: Prstačić
authors.forename: M
authors.initials: M
authors.lastname: Jurlina
authors.forename: M
authors.initials: M
authors.lastname: Žižić-Mitrečić
authors.forename: S
authors.initials: S
authors.lastname: Janjanin
mesh_terms: D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006101:Granuloma, Giant Cell / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009302:Nasopharyngeal Diseases / Q000175:diagnosis*; D012220:Rhinitis / Q000175:diagnosis*; D012852:Sinusitis / Q000175:diagnosis*; D014376:Tuberculosis / Q000175:diagnosis*