Laryngeal tuberculosis: a diagnosis not to be missed.

A 66-year-old Caucasian female was referred to the ear, nose and throat outpatient by her general practitioner with complaints of worsening sore throat, hoarseness of voice and productive cough for 3 months. The patient also had a history of rigors and evening temperature. She was using long-term steroids for nephrotic syndrome. The patient was treated for pulmonary tuberculosis as a child. An exophytic left supraglottic mass involving the left aryepiglottic fold, epiglottis and left vocal cord was revealed on fibre-optic laryngoscopy. The diagnosis of laryngeal tuberculosis was confirmed on repeat biopsy. The sputum smear was also positive for acid-fast bacilli. Chest x ray reported fibrosis of the right upper lobe indicating tuberculosis. The patient was started on anti-tuberculous treatment and made a steady recovery. There is reactivation of pulmonary tuberculosis in our case report with secondary involvement of larynx probably due to long-term use of steroids for nephrotic syndrome.