Head and Neck Manifestations of Tuberculosis

Isoniazid-Resistant Tuberculosis of the Parotid Gland Masquerading as a Benign Neoplasm

“…Subin Lee, BS 1 , Lisa M. Chirch, MD 2 , Lynn Sosa, MD 3 , Qian Wu, MD 4 , and Todd E. Falcone, MD 5 A 38-year-old female presented with a 12-month history of a palpable mass below her left ear that had been stable in size. She denied any fevers, chills, night sweats, cough, or weight loss.…”

“…2 Within the head and neck, cervical lymphadenopathy accounts for the majority of cases, followed by laryngeal TB and tuberculous otitis media. 3,4 Tuberculosis of the parotid gland is rare even in endemic regions of the world. 3 The typical clinical presentation of parotid gland TB is insidious onset of a slow-growing, asymptomatic localized lesion within the gland.…”

“…Compared to a typical patient with malignancy, these patients present at a younger age, usually 30s to 50s. 3,4 The detection of mycobacterial species on culture remains the gold standard for diagnosing TB disease. 3,4 However, a culture-confirmed diagnosis may be elusive, as demonstrated by our patient in which a culture was not initially performed due to lack of suspicion.…”

“…3,4 The detection of mycobacterial species on culture remains the gold standard for diagnosing TB disease. 3,4 However, a culture-confirmed diagnosis may be elusive, as demonstrated by our patient in which a culture was not initially performed due to lack of suspicion. Furthermore, the negative AFB stain on the surgical specimen suggested a paucity of organisms so it is unclear if a culture would have yielded growth.…”

Primary tuberculosis of the palate

“…Although pulmonary forms are predominant, a significant proportion of patients (15–25%) manifest active infection in an extrapulmonary site 1. However, TB with oral expression is considered rare.…”