Behcet Disease: When Laryngeal Tuberculosis Unforeseably Strikes

Abstract

Behçet disease (BD) is a chronic vasculitis that can affect all organs, particularly

the skin, mucous membranes, eyes and joints. It can lead to severe complications

requiring immunosuppressive therapy (IS). Although the prescription of IS is

indisputable and life-saving, they carry a significant risk of opportunistic

infections. Tuberculosis is an infectious disease primarily caused by the bacterium

Mycobacterium tuberculosis, also known as Koch's bacillus. It predominantly

affects the lungs due to airborne transmission and favorable conditions for the

bacillus's survival in this area; however, it can also affect other sites to a lesser

extent, such as the brain, bones, skin and « ear, nose and throat » (ENT) regions.

Laryngeal tuberculosis (LT) is a rare and underdiagnosed localization that often

occurs in immunocompromised patients. This article reports the case of a patient

with BD under IS who developed LT secondary to subclinical pulmonary

tuberculosis. The outcome after discontinuing azathioprine and initiating

antituberculous treatment was favorable. The case report aims to shed light on

the rare and underrecognized presentation of tuberculosis in BD and in case of

immune vulnerability, unraveling the intricate interplay between

immunosuppression and opportunistic infections. Its significance lies in

underscoring the critical need for heightened clinical vigilance, as LT can

masquerade as BD-related manifestations, posing diagnostic dilemmas.