A Rare Case of Primary Nasal Tuberculosis.

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.