bubble_chart Overview

Pharyngeal tuberculosis is a chronic systemic infectious disease caused by Mycobacterium tuberculosis. Various organs can be affected, but pulmonary tuberculosis is the most common. Pharyngeal tuberculosis often occurs when the pharyngeal mucosa is injured by contact with Mycobacterium tuberculosis from the sputum of pulmonary tuberculosis patients, or spreads upward from laryngeal tuberculosis, and can also result from hematogenous dissemination of Mycobacterium tuberculosis. Isolated pharyngeal tuberculosis is less common than laryngeal tuberculosis. Pharyngeal tuberculosis often causes severe malnutrition due to pain and difficulty swallowing.

bubble_chart Clinical Manifestations

Nasopharyngeal subcutaneous nodes often present with mucosal ulcers or granuloma formation. Patients may experience symptoms such as stuffy nose, nasal discharge, and hearing loss. Tonsillar subcutaneous nodes often have no obvious symptoms and are referred to as latent subcutaneous nodes, accompanied by cervical subcutaneous lymphadenitis. Pharyngeal subcutaneous nodes are generally classified into two types: acute foxtail millet type and chronic ulcer type.

1. Acute foxtail millet-type pharyngeal subcutaneous nodes These often occur secondary to active open pulmonary subcutaneous nodes or miliary pulmonary subcutaneous nodes. They are a manifestation of systemic immunodeficiency and a severe malignant complication of pulmonary subcutaneous nodes. Patients exhibit high fever, extremely poor general condition, and intense pharyngeal pain, especially during swallowing, often radiating to the ears. In the early stages, multiple foxtail millet-like nodules appear beneath the mucosa, rapidly ulcerating to form irregularly edged ulcers covered with gray-yellow, foul secretions. They commonly occur in the soft palate, posterior pharyngeal wall, and lateral pharyngeal wall. They may also develop in the tonsils and other areas, often spreading to the oral cavity and larynx.

2. Chronic ulcer-type pharyngeal subcutaneous nodes These progress more slowly, with symptoms other than swallowing pain being less noticeable. They typically occur in the palatopharyngeal arch and posterior pharyngeal wall, presenting as localized infiltrative lesions on pale, edematous mucosa. These later ulcerate to form superficial ulcers, which may be confined to one or several areas, with irregular, rodent-bite-like edges covered by gray-yellow pseudomembranes. If secondary infection occurs, the ulcers may necrotize and deepen, forming undermined edges.

bubble_chart Diagnosis

A biopsy can confirm the diagnosis. Based on medical history, clinical manifestations, and relevant laboratory tests, the primary lesion can be identified.

bubble_chart Treatment Measures

Systemic anti-tuberculosis treatment is most important. Local treatment primarily aims to alleviate pain and difficulty swallowing. For example, a 0.5–1% dicaine spray can be applied to the throat before meals to temporarily relieve pain. For chronic ulcerative cases with limited lesions, cauterization with 50–80% lactic acid, 20% silver nitrate, or chromic acid can be used to promote ulcer healing. Locally, a 1% streptomycin solution can be used for gargling or throat spraying. Food and drinks should not be too hot or too cold, ideally at body temperature. Additionally, attention should be paid to increasing nutrition and maintaining oral hygiene.