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Se presenta un caso de una mujer de 43 años, valorada por un cuadro insidioso de disnea progresiva con odinofagia. Tras las primeras evaluaciones por el servicio de Otorrinolaringología, se realiza biopsia a través de fibrobroncoscopia de lesiones obeservadas en epiglotis. La anatomía patológica de la lesión confirmó la presencia de bacilos de Mycobacterium tuberculosis. Las formas clásicas de tuberculosis laríngea muestran estadíos avanzados de lesiones pulmonares y afectación clínica grave, siendo raros los casos de afectación paucisintomática.

Abstract The purpose of this study was to increase our knowledge about Mycobacterium africanum and report the incidence and characteristics of tuberculosis (TB) due to their lineages in Aragon, Spain, over the period 2003–2019. The study includes all the cases in our region, where all the M. tuberculosis complex isolates are systematically characterised. We detected 31 cases of M. africanum among 2598 cases of TB in the period studied. TB caused by M. africanum is rare (1.19%) in our population, and it affects mainly men of economically productive age coming from West African countries. Among the isolates, Lineage (L) 6 was more frequent than L5. The genotyping of these strains identified five clusters and 13 strains with a unique pattern. The isolates’ characterisation identified a copy of IS6110 within the moaX gene, which turned out to be specific for L6. It will allow the differentiation of this lineage from the rest of MTBC with a simple PCR reaction. It remains to be established whether this polymorphism may limit M. africanum transmission. Furthermore, a mutation in the mutT2 promoter was found as specific for L6 strains, which could be related to the high variability found for L6 compared to L5.