Primary tuberculosis of the tonsil

SummaryTuberculosis (Tb) has been called the great simulator, its vast number of clinical manifestations often makes differential diagnosis a difficult task. Tb is an endemic illness in Mexico. This disease is caused by Mycobacterium tuberculosis in most of the cases. These pathogens are acid-alcohol resistant bacteria that produce chronic lesions. The most frequent lesion is the granuloma.The bacilli can affect any system or organ producing non-specific clinical features and manifestations including fatigue, weight loss, fever, and chronic cough. The initial infection is located in the lungs in 98% of the cases [C.R. Olvera, G.L.E. Pérez, C.J. Villalba, Drug resistant tuberculosis in Mexico. The experience of the National Institute of Respiratory Diseases of Mexico, Int. J. Tuberc. Lung Dis. (1997) S-52; C.R. Olvera, G.L.E. Pérez, Resistencia secundaria en tuberculosis, Rev. Inst. Nal. Enf. Resp. Mex. 6 (1993) 185–190]. Dissemination of the bacilli throughout the body with secondary affection of different organs causes military Tb. This variant of the Tb infection causes a higher mortality rate. The number of inoculated bacilli mostly determines evolution of this illness. Other factors are its multiplication, and the resistance and sensibility of the host [O. Celik, S. Yalcin, A. Hancer, P. Celik, R. Ozercan, Tuberculous tonsillitis, J. Otolaryngol. 24 (5) (1995) 307–309].There have been reports of secondary Tb affecting the Waldeyer's ring. Here we present a case of a 16-year-old male patient with primary Tb of the tonsil.