A Rare Case of Parotid Gland Tuberculosis

Abstract

Parotid gland tuberculosis is a very rare form of extrapulmonary tuberculosis, with less than 200 cases reported in literature. We describe a 10-year-old female who presented with a swelling in the left parotid region during the last month. CT scan neck revealed an abscess in the left parotid gland extending into the submandibular gland, muscles, and bone. Pus aspirated by FNAC showed acid fast bacilli in the ZN stain, and GeneXpert was positive for rifampicin-sensitive Mycobacterium tuberculosis. She was successfully treated with antituberculous therapy given for 6 months. Parotid gland tuberculosis, although rare, has a good prognosis with drug therapy. Surgery is rarely required.

Idiopathic Parotid Gland Abscess in a Pediatric Patient

“…Additionally, another retrospective study conducted at a rural tertiary care hospital further emphasized the rarity of parotid abscesses, noting that methicillin-susceptible Staphylococcus aureus was the most common pathogen and poor dental hygiene was the most important predisposing risk factor [10]. Isolated case reports note that tuberculosis is a possible cause of parotid abscesses that do not respond to antibiotic therapy [11,12]. However, the patient in this case did not display signs or symptoms of infection, including fever and general malaise.…”

Primary Extrapulmonary Rifampicin Mono-Resistant Tuberculosis of the Parotid Gland in an Indian Female: The World’s First Case

“…Tuberculosis of salivary glands is very rare and that of the parotid glands is the rarest of rare clinical presentations [6]. Further, rifampicin mono-resistance has never been reported in parotid glands.…”

“…Birkent et al in 2008 reported that it requires a very high index of suspicion, especially in the absence of any symptoms of tuberculosis or any history of contact [4]. The rarity of this clinical entity could result in missed diagnosis and superfluous parotidectomies [6].…”

“…Lymph nodes of the cervical region and those around the salivary glands are commonly involved [ 5 ]. Tuberculosis of salivary glands is very rare and that of the parotid glands is the rarest of rare clinical presentations [ 6 ]. Further, rifampicin mono-resistance has never been reported in parotid glands.…”