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Recently, the news of the sudden death of the actress Namtaan from The Star has greatly alarmed society. The sudden death occurred without any prior signs of illness. The announcement that the cause of death was “nasopharyngeal tuberculosis” raised even more questions, as most people may not have known that tuberculosis can occur in places other than the lungs. Therefore, to create broader understanding and awareness, leading to prevention and self-care to avoid risks, today we will learn more about nasopharyngeal tuberculosis.
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<h4 style="color: #008080;">Nasopharyngeal Tuberculosis is Rarely Found 
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Nasopharyngeal tuberculosis is actually caused by the same tuberculosis infection found in the lungs, which is an infection by “Mycobacterium Tuberculosis”. Although it is most commonly found in the lungs, tuberculosis can actually occur in various organs throughout the body, such as the larynx, throat, lymph nodes in the neck, pericardium, or even bones. Nasopharyngeal tuberculosis is considered very rare, accounting for less than 1% of all tuberculosis cases worldwide.
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<h4 style="color: #008080;">What Are the Symptoms of Nasopharyngeal Tuberculosis and Why Is It Called a Silent Threat? 
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As is well known, a key symptom of tuberculosis is a “cough” that is chronic or bloody. If such abnormalities are observed, it can alert us to a serious problem. However, “nasopharyngeal tuberculosis” differs in that most symptoms are quite general and not severe. It may show no symptoms or resemble a common cold, such as fever, runny nose, nasal congestion, snoring (due to a mass behind the nasopharynx), night sweats, weight loss, nosebleeds, and possibly muscle aches. These symptoms hardly indicate a serious disease, causing most patients with nasopharyngeal tuberculosis to be unaware and diagnosed late.
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Patients with nasopharyngeal tuberculosis do not usually show a prominent cough like those with pulmonary tuberculosis, but they can have severe coughing or bloody cough if pulmonary tuberculosis is also present. Because nasopharyngeal tuberculosis lacks clear symptoms, it becomes a frightening silent threat. It is only detected when patients undergo endoscopic examination, which may reveal a mass behind the nasopharynx with varying appearances, such as a large, clearly visible mass that can be diagnosed easily, or just a small raised area. In some cases, no mass or abnormalities are found, making it impossible to definitively diagnose the disease, turning it into a silent threat that can eventually become seriously dangerous.
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<h4 style="color: #008080;">Is It Treatable and How Once Diagnosed with Nasopharyngeal Tuberculosis? 
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Diagnosis of nasopharyngeal tuberculosis is done by taking a medical history, asking about symptoms, combined with endoscopic examination, and biopsy for staining and culture to confirm the presence of tuberculosis bacteria. This step is the most difficult because the infection may not be detected, allowing the disease to progress severely. However, if tuberculosis is confirmed, it can be completely cured with medication. The duration of treatment depends on consistent medication intake and following the doctor’s advice. Typically, treatment lasts about 6 months, and if there are no complications and medication is taken as prescribed, the patient can be cured of tuberculosis.
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<h4 style="color: #008080;">Who Is at the Highest Risk for Nasopharyngeal Tuberculosis? 
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Some research reports indicate that even healthy individuals can develop nasopharyngeal tuberculosis. Therefore, it can be said that “we all have some risk” of developing nasopharyngeal tuberculosis. The likelihood depends on how well one takes care of their health and maintains a strong immune system. Certainly, those at higher risk are people with respiratory problems or poor health, especially patients with pulmonary tuberculosis, who have a very high chance of also having nasopharyngeal tuberculosis.
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<h4 style="color: #008080;">How to Screen for Risk and Stay Safe from Nasopharyngeal Tuberculosis 
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Whether it is nasopharyngeal tuberculosis, pulmonary tuberculosis, or tuberculosis in other organs, the main principle for minimizing risk and staying safe from tuberculosis infection is the same: “take care to avoid exposure to infection as much as possible”. Most tuberculosis infections occur in community settings or through close contact with tuberculosis patients, increasing the chance of spreading the bacteria from carriers or infected individuals to others.
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Therefore, the easiest and most effective way to prevent and protect yourself from tuberculosis is by wearing a mask. For effective protection, an N95 mask is recommended because it better prevents tuberculosis and other infections. Additionally, frequent hand washing and maintaining good health are important because a strong immune system reduces the chance of tuberculosis infection. Lastly, regular health check-ups should not be neglected, as nasopharyngeal tuberculosis does not show clear symptoms to indicate illness.
“Although tuberculosis is dangerous, it can be cured if detected early 
Therefore, do not be careless or neglect health check-ups and self-care 
because you might unknowingly have tuberculosis bacteria in your body today.”

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Dr. Naparat Jirawatpalin 
Specialist Surgeon in Ear, Nose, and Throat 
and Facial Plastic Surgery 
Ear, Nose, and Throat Center, Phyathai 3 Hospital

More dangerous than ordinary tuberculosis, scarier than any type of tuberculosis because it is a silent threat that we may not realize we have, and it can cause the disease to spread extensively and become seriously dangerous. This is "nasopharyngeal tuberculosis," a type of tuberculosis you might have but don't know.

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Nasopharyngeal Tuberculosis: A Silent Disease... That Can Be Life-Threatening

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