Prolonged tonsilitis with poor response to therapy: a rare case of extrapulmonary tuberculosis

Abstract

Tonsillitis is a benign and extremely common infection of the upper airway, secondary to the colonization of the normal bacterial flora of the oral cavity and exposure to pathogenic microorganisms of adjacent tissues. Such patients benefit from systemic antibiotics based on penicillins, macrolides and lincosamides. However, recurrent episodes, prolonged odynophagia, atypical manifestations, or poor response to antimicrobial therapy, forces consideration of diagnostic possibilities other than the obvious, including Mycobacterium tuberculosis as the etiological agent, especially in countries with the highest rates of tuberculosis. The following is a case report of an immunocompetent adult patient who was a recurrent user of Emergency Department services for repetitive odynophagia secondary to Mycobacterium tuberculosis tonsillitis, that serves to demonstrate an atypical presentation of extrapulmonary tuberculosis.