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Primary sinonasal tuberculosis in a Nigerian woman presenting with epistaxis and proptosis: A case report

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September 1, 2009
by B. Sulyman Alabi, FWACS, Enoch A.O. Afolayan, FMCPath, A. Abdulakeem Aluko, FWACS, O. Abdulraman Afolabi, MBBS, and F. Grace Adepoju, FWACS


Tuberculosis is the second leading cause of death worldwide after human immunodeficiency virus/AIDS and is especially prevalent in developing countries. We report a case of primary sinonasal tuberculosis without pulmonary involvement, which is rare, in a 27-year old female Nigerian fish farmer. She had a 3-year history of right-eye proptosis, bilateral nasal masses, and epistaxis. Cranial computed tomography suggested an extensive sinonaso-orbital neoplastic lesion. We performed a right external frontoethmoidectomy. Histologically, the excised nasal polyps revealed tuberculosis. Six months of antituberculosis therapy provided satisfactory improvement. Sinonasal tuberculosis, despite its rarity, should be added to the differential diagnosis of nasal and paranasal sinus disorders, and histologic evaluation remains the hallmark of diagnosis. Therapy with a short-duration, multidrug combination, rather than the longer-duration treatment regimen hitherto used, could be quite valuable, especially in the setting of a developing country with poor patient compliance.

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