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Kamal N, Aden D, Sufian Z, Singh M. Cytology as a rapid tool in diagnosing tuberculosis of the parotid gland: A case series with a review of the literature. Diagn Cytopathol 2022; 50:E344-E350. [PMID: 35924792 DOI: 10.1002/dc.25023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022]
Abstract
Tubercular infection of the parotid gland often confuses clinicians, it being a rare entity even in an endemic area. Its similarity in presentation with that of parotid neoplasms, nonspecific symptoms, low incidence and non-contributory radiological findings often leads to its misdiagnosis as parotid neoplasm, which in the due course results in parotidectomy. Therefore, FNAC of parotid swelling is helpful to avoid unnecessary surgery and patient discomfort. We report four cases of FNAC of parotid swelling with suspicion of neoplasm/inflammatory lesion and were diagnosed as tuberculosis of the parotid gland. They were advised antitubercular drugs for 6 months and followed up. These case are reported not just to highlight that parotid is a rare site for tuberculosis, but also to ascertain that FNAC can be an easy and fast diagnostic modality for confirmation of tubercular parotitis rather than going through the long way of resection and confirmation on histopathology.
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Affiliation(s)
- Nidhi Kamal
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Durre Aden
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Zaheer Sufian
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mukul Singh
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Miura R, Nakamura K, Matuzaki H, Oshima T. A Case of Parotid Gland Tuberculosis Suspected to be Malignant Tumor. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02902-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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3
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Abstract
Tuberculous lymphadenitis is the most common extrapulmonary manifestation of disseminated tuberculosis (TB). It is considered to be the local manifestation of the systemic disease that has disseminated to local lymph nodes, but a high index of suspicion is needed for the diagnosis, because there are several infectious and noninfectious diseases that can mimic the same clinical picture. In recent years, different diagnostic methods have been introduced, including fine-needle aspiration cytology, which has emerged as a simple outpatient diagnostic procedure that replaced the complete excisional node biopsy, and a number of molecular methods which have greatly improved diagnostic accuracy. This chapter covers the most actual knowledge in terms of epidemiology, clinical manifestations, pathogenesis, and treatment and emphasizes current trends in diagnosis of tuberculous lymphadenitis. TB parotid gland involvement is extremely rare, even in countries in which TB is endemic. Because of the clinical similarity, parotid malignancy and other forms of parotid inflammatory disease always take priority over the rarely encountered TB parotitis when it comes to differential diagnosis. As a result, clinicians often fail to make a timely diagnosis of TB parotitis when facing a patient with a slowly growing parotid lump. This chapter highlights the most important features of this uncommon disease.
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4
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Abstract
Objectives: Our aim was to better understand the rarely encountered tuberculous (TB) parotitis. Methods: A case of TB parotitis is reported, and the literature is reviewed. Results: Forty-nine patients (27 men, 22 women; mean age, 38.3 ± 16.4 years) were enrolled. The median duration of symptoms before these patients sought medical help was 6 months. Except for 1 patient with bilateral TB parotitis, all had unilateral involvement; complications included draining sinuses in 4 patients (8%) and facial palsy in 2 patients (4%). Twenty-one of 36 patients (58%) had a painless parotid mass, 12 of 19 (63%) had cervical lymphadenitis, 8 of 11 (73%) had fever, and 11 of 44 (25%) had pulmonary tuberculosis (4 active and 7 inactive cases). Neoplasm was the most common presumptive diagnosis. The diagnosis of TB parotitis in most cases was made on the basis of cytologic analysis of the fine-needle aspirate or histopathologic analysis of the excised tissue. Forty-six patients with TB parotitis who had a traceable outcome survived after 6 to 10 months of antituberculosis chemotherapy. Conclusions: Physicians should have a high index of suspicion for TB parotitis in patients with a chronic parotid lump, even if the chest radiographs appear normal. Fine-needle aspiration should be performed first for diagnosis, and TB parotitis should be medically treated.
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Affiliation(s)
- Ing-Kit Lee
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan
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5
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Babazade F, Mortazavi H, Jalalian H. Parotid tuberculosis: a forgotten suspicion (a case report and literature review). Int J Dermatol 2012; 51:588-91. [DOI: 10.1111/j.1365-4632.2011.05014.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Tuberculosis of parotid is a rare clinical entity, and cases of bilateral tubercular parotitis are even rarer. We present a case of bilateral primary parotid tuberculosis in a 49-year-old female. The patient received anti-tuberculosis treatment for six months, resulting in complete resolution of the disease. We also review the theories related to the pathogenesis of tubercular parotitis, and propose a novel hypothesis about greater involvement of parotid gland as compared to other salivary glands in primary tuberculosis.
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Affiliation(s)
- JS Thakur
- Department of Otolaryngology-Head and Neck Surgery, I G Medical College, Shimla, India
| | - A Thakur
- Department of Pharmacology, I G Medical College, Shimla, India
| | - NK Mohindroo
- Department of Otolaryngology-Head and Neck Surgery, I G Medical College, Shimla, India
| | - S Mohindroo
- Department of Pathology, I G Medical College, Shimla, India
| | - DR Sharma
- Department of Otolaryngology-Head and Neck Surgery, I G Medical College, Shimla, India
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7
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Abstract
The parotid gland is the salivary gland most commonly affected by inflammation. However, infection of the salivary glands can occur in any of the glands. The most common pathogens associated with acute bacterial infection are Staphylococcus aureus and anaerobic bacteria. The predominant anaerobes include: anaerobic Gram negative bacilli (eg, pigmented Prevotella and Porphyromonas); Fusobacterium spp; and Peptostreptococcus spp. In addition, Streptococcus spp (including Streptococcus pneumoniae) and aerobic and facultative Gram-negative bacilli (including Escherichia coli) have been reported. Aerobic and facultative Gram-negative bacilli are often seen in hospitalized patients. Organisms less frequently found are Haemophilus influenzae, Treponema pallidum, Bartonella henselae, and Eikenella corrodens. Mycobacterium tuberculosis and atypical mycobacteria are rare causes of infection. The choice of antibiotics should be guided by identification of the etiologic agent.
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Affiliation(s)
- Itzhak Brook
- Georgetown University School of Medicine, 4431 Albemarle Street NW, Washington, DC 20016, USA.
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8
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Abstract
AbstractThe presentation of tuberculosis as an isolated parotid lump is rare. In this paper, six cases with tuberculous parotitis are reported which were evaluated as a benign parotid neoplasm in 216 specimens pre-operatively. All but one of them had no previous history of tuberculosis and all had a parotid lump as a sole symptom for at least one year. The diagnosis of tuberculosis was made, after superficial parotidectomy, by histopathology. Parenchymal involvement and intraparotid lymph node involvement with tuberculosis were seen in five and three patients, respectively. Two of the patients had lymph node involvement outside the parotid area. One of six patients had a coincidental Warthin tumour. A surgical approach is not only therapeutic but also diagnostic when other diagnostic tools fail.
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Tosun F, Tozkoparan E, Erdurman C, Ors F, Deniz O. Primary nasolacrymal tuberculosis diagnosed after dacryocytorhinostomy. Auris Nasus Larynx 2007; 34:233-5. [PMID: 17011734 DOI: 10.1016/j.anl.2006.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Revised: 06/09/2006] [Accepted: 07/21/2006] [Indexed: 11/16/2022]
Abstract
Although tuberculosis (TB) is common and well recognized in many countries, unusual presentations of the disease sometimes raise difficulties in differential diagnosis. Primary tuberculosis of the lacrimal sac and the nasolacrimal duct is an extremely rare presentation of extra-pulmonary tuberculosis. Dacryocystorhinostomy alone is not sufficient for the treatment of these patients and an anti-tuberculous therapy has to be added. Here we present a patient with primary tuberculosis, which is limited to the inferior meatus and filled the entire lacrimal sac on the left side. The patient underwent endoscopic dacryocystorhinostomy due to obstruction of the nasolacrimal duct and culture of the granulation tissue, taken from the lacrimal sac revealed mycobacterial tuberculosis. The patient was improved with anti-tuberculous therapy that was added to the surgery. Primary tuberculosis is a rare granulomatous disease of the nasolacrimal system, which should be considered in the differential diagnosis to plan the effective treatment.
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Affiliation(s)
- Fuat Tosun
- Department of ORL & HNS, Gülhane Military Medical School, Etlik 06018, Ankara, Turkey.
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10
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Abstract
This report describes the case of an elderly, diabetic man who developed acute suppurative parotitis with abscess formation. The causative agent of parotid abscess was Candida albicans, which is an unusual cause of salivary gland pathology. The parotid gland is the salivary gland most commonly affected by inflammation. Acute parotitis occurs most often in elderly patients who are debilitated by systemic disease or are in a state of dehydration following major surgical procedures. Despite the high prevalence of oral candida carriage, there have been few previous reports of candida sialoadenitis in the literature. This is due to the toxicity of saliva to fungi under normal conditions. The diagnosis of candidiasis in our patient was made by culturing the purulent discharge from Stensen's duct and by culture of the pus obtained at surgical drainage of the abscess. After incision and drainage, the patient was treated with intravenous and then oral fluconazole for a total of 4 weeks with complete resolution of his condition. This case is interesting in light of recent and ongoing investigations of salivary proteins as potential new antifungal agents.
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Affiliation(s)
- Ella Even-Tov
- Department of Otolaryngology-Head & Neck Surgery, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.
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11
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Chou YH, Tiu CM, Liu CY, Hong TM, Lin CZ, Chiou HJ, Chiou SY, Chang CY, Chen MS. Tuberculosis of the parotid gland: sonographic manifestations and sonographically guided aspiration. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:1275-1281. [PMID: 15448316 DOI: 10.7863/jum.2004.23.10.1275] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Involvement of the parotid gland by tuberculosis (TB) is rare. If treated properly, the prognosis of TB of the parotid gland is good. In this retrospective study, we report our experience with sonography and sonographically guided aspiration in the diagnosis of parotid TB. METHODS Over 12 years, 9 adults (mean age, 48 years) with parotid gland TB had been examined with high-resolution sonography and color Doppler sonography for their clinical problems of swelling on the mandibular angle. Sonographically guided fine-needle aspiration was done for cytologic study, stains for acid-fast bacilli, and cultures for mycobacterium. RESULTS The sonographic patterns were classified as chiefly the parenchymal type (4 patients) and chiefly the periparotid type (5 patients). The parenchymal type appeared as a diffusely enlarged, comparatively hypoechoic gland (compared with the contralateral asymptomatic gland), with or without focal intraparotid nearly anechoic zones, which might have a cavity or cavities within it. The periparotid type appeared as hypoechoic nodules located in the peripheral zone of the hyperechoic parotid gland, consistent with enlarged periglandular lymph nodes. The diagnosis of parotid TB was made in 8 of 9 patients on the basis of sonographically guided aspiration for acid-fast bacilli stains, cytologic study, and cultures for mycobacterium. CONCLUSIONS Sonographic examination contributes substantially in the diagnosis of parotid TB infection. In the presence of diffuse parotid echo pattern changes with periparotid lymphadenopathy, and with or without focal hypoechoic zones, TB infection should be differentiated. Sonographically guided fine-needle aspiration may provide further diagnostic information by means of stains, cultures, and cytologic study.
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Affiliation(s)
- Yi-Hong Chou
- Department of Radiology, Veterans General Hospital-Taipei, 201 Shih-Pai Rd, Section 2, Taipei, Taiwan, Republic of China.
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13
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Abstract
Tuberculosis of the parotid gland is rare. A 16-month-old US-born male infant with immigrant parents from Sudan presented to his primary care physician with periorbital cellulitis and preauricular lymphadenitis. He underwent incision and drainage of an abscess in the right intraparotid lymph node. The aspirate was positive for acid-fast bacilli by auramine-rhodamine stain and subsequently grew Mycobacterium tuberculosis. Antitubercular medications were started postoperatively.
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Affiliation(s)
- A Chatterjee
- Combined Division of Pediatric Infectious Disease, Creighton University, University of Nebraska Medical Center, 2500 California Plaza, Room 409, Criss II, Omaha, NE 68178, USA.
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Mert A, Ozaras R, Bilir M, Cicek Y, Tabak F, Tahan V, Ozturk R. Primary tuberculosis of the parotid gland. Int J Infect Dis 2001; 4:229-30. [PMID: 11231188 DOI: 10.1016/s1201-9712(00)90115-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- A Mert
- Department of Infectious Diseases, Cerrahpasa Medical Faculty, University of Istanbul 34303, Aksaray, Istanbul, Turkey
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15
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Abstract
Although rare, doctors and dentists should be aware of the possible occurrence of oral lesions of tuberculosis and consider them in the differential diagnosis of suspicious oral ulcers.
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Affiliation(s)
- D P Von Arx
- Maxillofacial Unit, Kent & Canterbury Hospital.
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Zeller V, Charlois C, Duvivier C, Bricaire F, Katlama C. Pseudo-Primary Infection Syndrome following Discontinuation of Antiretroviral Therapy. Antivir Ther 2001. [DOI: 10.1177/135965350100600305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report the case of a retroviral rebound syndrome associated with parotid gland enlargement in a chronically HIV-infected man.
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Affiliation(s)
- Valérie Zeller
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
| | - Cécile Charlois
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
| | - Claudine Duvivier
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
| | - François Bricaire
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
| | - Christine Katlama
- Département des Maladies Infectieuses et Tropicales, Hôpital Pitié-Salpêtrière, Paris, France
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Abstract
Acute infection can involve any salivary gland, but it predominately affects the major salivary glands, especially the parotid gland. The anatomic and physiologic factors accounting for the parotid gland's predilection for infection are reviewed. Numerous conditions that are predisposed to acute bacterial sialadenitis and differ from risk factors associated with viral infection are also reviewed. The pathogenesis, diagnostic evaluation, treatment, complications, and prognosis of bacterial infections are discussed and contrasted with those of viral infections.
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Affiliation(s)
- S J McQuone
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19107, USA.
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Güneri EA, Ikiz AO, Atabey N, Izci O, Sütay S. Polymerase chain reaction in the diagnosis of parotid gland tuberculosis. J Laryngol Otol 1998; 112:494-6. [PMID: 9747486 DOI: 10.1017/s0022215100140885] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A parotid gland mass with presenting features of malignancy is a diagnostic and therapeutic challenge. The histological nature of the lesion must be clearly determined before proceeding with facial nerve sacrificing surgery. Although rare, tuberculosis of the parotid gland must be included in the differential diagnosis of a parotid gland mass especially when the social characteristics of the patient suggests a mycobacterial infection. Primary tuberculosis of the parotid gland is generally encountered among populations with a high incidence of pulmonary disease. The difficulty in the differential diagnosis of a parotid gland malignancy may be helped by a high degree of clinical suspicion, since laboratory tests generally do not identify the specific causative organism. This article reports the first case of parotid gland tuberculosis with clinical and radiodiagnostical features simulating malignancy in which the diagnosis was confirmed by the polymerase chain reaction (PCR).
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Affiliation(s)
- E A Güneri
- Department of Otolaryngology Head and Neck Surgery, Dokuz Eylül University Medical School, Izmir, Turkey.
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