Tuberculosis (TB) in the throat is a rare type of TB that affects the larynx. It’s often misdiagnosed but has symptoms such as hoarseness and painful swallowing. If treated promptly, it can be fully cured.

Tuberculosis (TB) is an infectious disease that mainly affects the lungs, though it can affect almost any part of the body. Tuberculosis in the throat, also called laryngeal tuberculosis (LTB), is a rare type of TB that affects the voice box, also called the larynx. It may cause symptoms such as hoarseness, painful swallowing, and shortness of breath.

LTB most often occurs when a TB infection in the lungs travels to the larynx. However, in rare cases, LTB may be confined to the larynx. This is called primary LTB. Primary LTB is not common and accounts for less than 1% of all TB cases.

Laryngeal tuberculosis is curable, provided you begin prompt antibiotic treatment and complete the full course of medication.

LTB mainly affects the laryngeal structures at the front of the neck, such as:

  • the thyroid cartilage
  • the vocal folds
  • the epiglottis, which is a flap of cartilage that prevents food and drink from entering the windpipe, or trachea, during swallowing

In LTB, one or more of the above structures may become swollen, inflamed, or ulcerated, causing symptoms.

The most common symptoms of LTB are:

Hoarseness is the most common symptom of LTB and occurs when the TB infection causes lesions to form on the vocal folds. Around 1 in 5 people with LTB also experience other changes to their voice.

A severe TB infection in the larynx can cause extreme swelling of the vocal folds. This can result in airway obstruction and rapid respiratory distress. Without prompt treatment, this could progress to respiratory failure, where not enough oxygen passes from the lungs to the blood.

Other symptoms of TB are only present during an active infection. Some general signs and symptoms of active TB include:

Most people with LTB also have TB lesions in their lungs. They may experience additional symptoms, such as chest pain and coughing up blood or mucus.

The M. tuberculosis bacterium that causes TB is an airborne pathogen, meaning it can spread through the air in tiny droplets of saliva. If you inhale these pathogens, you could acquire a TB infection. If a person has active TB, they can spread these pathogens when they cough or speak.

If your immune system is unable to keep the M. tuberculosis in check, the bacteria that enter your respiratory system can multiply, causing symptoms. This is what doctors refer to as “active TB.” The pathogens may also travel through your circulatory system to other parts of your body.

If your immune system can keep the M. tuberculosis in check, then you do not develop TB symptoms. This is considered “inactive TB.” However, if you do not receive antibiotic treatment for inactive TB, you may develop active TB at any time and become sick.

Most cases of LTB occur when a Mycobacterium tuberculosis infection inside the lungs migrates to the larynx. However, in rare cases, the bacterium may propagate in the larynx itself, without making its way to the lungs.

Types of tuberculosis

There are three main TB disease types, or classifications:

  1. Pulmonary TB disease: This type occurs in the lungs and is the most common.
  2. Extrapulmonary TB disease: This type occurs in areas other than the lungs. Examples include:
    • Laryngeal tuberculosis: This type affects the larynx.
    • Scrofula: This type affects the lymph nodes.
    • Pleural tuberculosis: This affects the pleura, which is the thin layer of tissue covering the lungs.
    • Meningeal tuberculosis: This affects the meninges, which are the thin layers of tissue surrounding the brain and spinal cord.
    • Renal tuberculosis: This type affects the kidneys.
    • Skeletal tuberculosis: This type affects the bones.
  3. Disseminated TB disease: This type occurs when the M. tuberculosis bacteria travels via the bloodstream to all parts of the body, where they multiply and cause disease in multiple sites.

As a 2023 research review explains, the diagnostic procedure for LTB is complex and often misdiagnosed. This is partly due to the rarity of the disease and partly due to the lack of specific symptoms. For example, doctors may attribute early LTB symptoms to more common conditions, such as:

If the doctor thinks that you may have TB, they’ll order a TB blood test or a TB skin test to confirm that the infection is present in your body.

If your TB test comes back positive and you’re experiencing symptoms, your doctor may diagnose you with active TB. However, additional tests can confirm the diagnosis and include:

The treatment for LTB is a 6-month antibiotic drug regimen to help destroy the bacteria causing the TB.

Doctors will prescribe a combination of the following four antibiotics during the first 2 months of treatment:

Doctors will then prescribe isoniazid and rifampicin for the following 4 months of treatment.

In some cases, doctors may extend the antibiotic treatment regimen from 6 to 12 months.

A 2024 case report notes that the above drug regimen leads to improvement in LTB symptoms within around 18 weeks. This can completely cure LTB without complications, as long as treatment begins immediately after diagnosis, and the treatment course is completed.

If your doctor prescribes antibiotics for LTB, it is essential that you complete the full treatment regimen, even if you begin to feel better. Stopping the treatment early can lead to drug-resistant or multi-drug-resistant TB. The latter is very dangerous, and its treatments can cause severe side effects.

Below are some answers to frequently asked questions about LTB.

Is tuberculosis of the throat curable?

Laryngeal tuberculosis is curable if a person begins antibiotic treatment early and completes the full course of treatment.

Is tuberculosis of the throat contagious?

Laryngeal tuberculosis indicates active TB disease. Active TB is contagious, meaning it can spread from one person to another.

How long does tuberculosis of the throat last?

In a 2019 study of 15 cases of LTB, the duration of illness prior to diagnosis and subsequent treatment ranged from 1 month to 18 months, with the average being 9.5 months. These cases resolved fully with treatment.

Tuberculosis (TB) is an infectious disease that mainly affects the lungs, though it can affect almost any part of the body. Tuberculosis in the throat is a rare type of TB that affects the larynx. Most cases start in the lungs and spread to the larynx, though a small number are confined to the larynx.

Laryngeal tuberculosis may cause symptoms such as hoarseness, painful swallowing, and shortness of breath. Other symptoms may include a cough, fever and chills, and a loss of appetite. If you also have TB in your lungs, you may experience additional symptoms, such as chest pain and coughing up blood or mucus.

Laryngeal tuberculosis is curable as long as you begin antibiotic treatment promptly and complete the full course of treatment.