Amongst some of the less frequent forms of tuberculosis identified in the patient files of Stannington Sanatorium are manifestations of the eyes, ears and throat.

Eyes
Patient 83/19 was diagnosed with TB Plus group II, but upon admission it was noted that they had phlyctenular conjunctivitis in the right eye. This is a hypersensitivity response in the cornea or conjunctiva to microbial proteins such as tubercle bacilli and often presents in undernourished children coming from poor social conditions. Demonstrating as a yellowish-grey nodule near the limbus of the eye with an area of hyperemia, there is a tendency for these to ulcerate, disappear and be superceded by another lesion. Once the cornea becomes involved, there can be substantial pain accompanied by the secretion of tears and photophobia. A letter attached to the patient's case file states her eye condition to be tuberculous. She was prescribed atrophine drops, to relax the eye muscles, to be applied to the eye lids each night. It was also requested that dark glasses be provided for during the day due to the photophobia. Tuberculosis can manifest in numerous parts of the eye and can either be involved as a result of primary infection, with the tubercle bacilli entering directly through the eye, or secondary infection, as the result of contagious spread from an adjacent structure or through haematogenous spread.

Ears
Tuberculosis of the middle ear is usually secondary to infection in the lungs, larynx or nose. Infection can also take hold through the external auditory canal or through haematogenous spread which can also involve the mastoid bone resulting in necrosis and progression to the middle ear. It thought that children are more affected than adults. Patient 60/1949 was admitted from the RVI, Newcastle with TB of the middle ear. She had presented with left sided otorrhoea associated with a post-aural abscess which did not clear up with penicillin. In March 1949 the mastoid bone was opened to reveal a mass of tubercular granulations which had destroyed the whole of the middle ear cleft. Surgical intervention was undertaken for this patient clearing the soft granulations from around the lateral sinus and as far back as the petrosal sinus. A biopsy report confirmed the tuberculous nature of the infection but x-rays of the chest indicated no TB complex. Streptomycin was administered through a drainage tube directly into the mastoid for a further 18 days and local treat thereafter was limited to mopping any discharge from the ear. Despite the severity of this girl's condition, the mastoid cavity epithelialised nicely and no further interference was necessary.

Throat
Patient 92/1952 was diagnosed with Primary TB and questioned TB of the larynx. Tuberculosis of the larynx can occur as a primary infection but is usually secondary to primary infection of the lungs. Symptoms of this type of tuberculosis can include a cough, hoarse voice, sore throat, dysphagia and haemoptysis. This patient was considered to have had a right lung primary complex for some months prior to admission with a deterioration in her cough and the development of a husky voice. She was seen at the RVI, Newcastle, where it was discovered she had smooth oedema on both vocal cords but without a surface breach and in the uncertainty of tuberculous infection in the larynx was put forward for sanatorium treatment, being transferred to Stannington, and voice rest. Two months after admission further investigation of the larynx revealed that the oedema had reduced in size and had been obstructing a traumatic lesion. On questioning the patient it was discovered that this traumatic tear to the throat had been the result of shouting. As such the case was dismissed as incidental and the larynx would heal in time with rest. No tuberculosis was found in the larynx.