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Tuberculous parotitis: case report and literature review
1Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan.
The Annals of Otology, Rhinology, and Laryngology
|September 2, 2005
Summary
Tuberculous (TB) parotitis is rare but should be suspected in patients with chronic parotid lumps. Early diagnosis via fine-needle aspiration and medical treatment lead to good outcomes.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Microbiology
Background:
- Tuberculous (TB) parotitis is an uncommon manifestation of Mycobacterium tuberculosis infection.
- It often presents insidiously, mimicking other parotid gland pathologies.
Observation:
- A review of 49 patients with TB parotitis revealed a median symptom duration of 6 months.
- Unilateral parotid involvement was most common (98%), with complications including draining sinuses (8%) and facial palsy (4%).
- Associated symptoms included cervical lymphadenitis (63%) and fever (73%), while 25% had pulmonary TB.
Findings:
- Neoplasm was the most frequent initial presumptive diagnosis.
- Fine-needle aspiration cytology or histopathology confirmed TB parotitis.
- Antituberculosis chemotherapy resulted in survival for 46 patients with traceable outcomes.
Implications:
- Clinicians should maintain a high index of suspicion for TB parotitis in cases of chronic parotid masses, even with normal chest X-rays.
- Fine-needle aspiration is the recommended initial diagnostic procedure.
- Prompt medical management with antituberculosis drugs is crucial for successful treatment and patient survival.