# A Rare Case of Primary Nasal Tuberculosis

## TL;DR

A rare case of nasal tuberculosis was diagnosed and successfully treated with standard anti-tubercular therapy.

## Contribution

This paper presents a rare clinical case of primary nasal TB without pulmonary involvement.

## Key findings

- Nasal endoscopy and biopsy confirmed primary nasal TB with caseating granulomas and acid-fast bacilli.
- Standard anti-tubercular treatment resolved symptoms completely with no recurrence after one year.

## Abstract

Primary nasal tuberculosis (TB) is an exceedingly rare form of extrapulmonary TB, often mimicking other granulomatous diseases and posing diagnostic challenges. We present a case of a 54-year-old female patient with persistent nasal obstruction and epistaxis, initially suspected to be chronic rhinosinusitis. Diagnostic evaluation, including nasal endoscopy and biopsy, revealed caseating granulomas with acid-fast bacilli (AFB), confirming primary nasal TB without pulmonary involvement. The patient was treated with a standard anti-tubercular regimen of two months of intensive phase (four drugs) and four months of continuation phase (three drugs), resulting in complete resolution of symptoms and no recurrence at one-year follow-up. This case underscores the importance of considering TB in atypical nasal presentations, especially in endemic regions, and highlights the efficacy of timely anti-tuberculous therapy.