Parotid tuberculosis in a young child causing moth-eaten mandibular osteomyelitis: an elusive diagnosis

Tuberculosis can affect almost any organ in the body and have unusual presentations. We hereby report a case of parotid tuberculosis causing osteomyelitis of the mandible in a 3-year-old child presenting with left-sided facial swelling since 4 months. There was a history of repeated incision and drainage for suspected parotid abscess elsewhere. Initial work-up was inconclusive. Radiology revealed a heteroechoic mass lesion of the left parotid gland with extensive destruction of the adjacent ascending ramus of the mandible suggesting an odontogenic tumor. Biopsy of the left parotid gland finally clinched the diagnosis of a tubercular abscess. The child responded remarkably well to antitubercular therapy. This case highlights the importance of complete work-up, including biopsy to avoid unwarranted surgical interventions.