Abstract
The patient was a 42-year-old female in whom a granulation lesion was detected at the maxillary sinus by ESS and postoperative re-biopsy revealed positive results in Ziehl-Neelsen staining and liquid culture. Thus, this case was diagnosed as paranasal tuberculosis. Because there was a shadow in the lungs and sputum smear examination showed positive results in Ziehl-Neelsen staining, the patient was hospitalized in the tuberculosis ward and received systemic administration of anti-tuberculosis drugs, which led to negative results in sputum smear examination. However, because a paranasal shadow remained on the images, ESS was performed. The resected specimens were all negative in culture of tubercle bacilli and tubercle bacilli DNA-PCR/Ziehl-Neelsen stainings. The negative results of the tubercule bacilli culture of the specimens were confirmed and oral administration of anti-tuberculosis drugs was discontinued. At present, one year and five months later, no recurrence of the lesion has been found. For cases of paranasal tuberculosis in which the administration of anti-tuberculosis drugs, results in insufficient, the sinus surgery and evaluation of the treatment effect are considered to be an effective method. In addition, in refractory nasal/paranasal diseases or those which cannot be identified, while suspecting nasal/paranasal tuberculosis, it is important to perform repeated biopsies, cultures, and PCR.
