Rare case of tubercular parotid abscess.

Acute parotitis progressing to parotid abscess is rare in children. Staphylococcus aureus is the usual pathogen in parotid abscess. Granulomatous parotid abscess due to tubercular aetiology is extremely rare. Authors report a case of chronic parotid abscess in a child who received multiple courses of antibiotics without any cure. The ultrasonography and CT scan of the parotid gland confirmed the extent of parotid abscess and the changes in the parotid lymph nodes. The surgical drainage and the biopsy of the lymph nodes lead to the diagnosis of granulomatous abscess. The antitubercular therapy finally cured the disease without further recurrence.

Massive sialadenitis resulting in critical airway after elective craniotomy: case report.

The authors report an unusual case of acute, rapidly progressive, unilateral neck swelling following extubation after elective left anterior temporal lobectomy with amygdalohippocampectomy. Due to severe neck swelling, the patient developed critical airway compromise, brachial plexopathy, and Horner's syndrome. After critical airway management and appropriate rehabilitation, the patient recovered completely and remains seizure free at 1.5 years of follow-up. This case highlights the importance of early recognition of acute postoperative sialadenitis and the steps needed to prevent serious morbidity and possible mortality from this rare complication.

What happens when oral tuberculosis is not treated?

Pulmonary tuberculosis (TB) is the most important form of the disease, although infection may also occur by way of the intestinal tract, tonsils and skin. Oral lesions consist of persistent ulcers or granulomatous masses. A 50 year old man had been diagnosed "necrotising granulomatous inflammation" following a biopsy of a lesion on lower lip, 21 months before at a medical centre. A chest-X-ray had not been performed and he had not been given any advise in respect of treatment. He was admitted to the hospital with cough, sputum, weakness, weight loss and lesions on his lower lip. In radiology, it was detected that he had supraclavicular, submental, cervical, mediastinal lymphadenopathies, pulmonary infiltrations with cavities, thickening and roughness on left oropharengial tonsil, thickenning on inner parts of larynx and bilateral surrenal thickening. The biopsy of lesions on larynx, tonsil and epiglottis revealed "necrotising granulomatous inflammation" and histopathology supported TB infection. Sputum acid-fast bacilli was positive and culture was positive for Mycobacterium tuberculosis complex. Two months of combination treatment resulted in a gradual relief of the symptoms, radiological response, disappearing of neck swelling and healing of lesions on lip, tonsil and larynx. Although unusual oral cavity manifestations of TB are rare, clinicians should be aware of possible occurrance.

Pediatric salivary gland lesions.

The salivary glands comprise three main pairs of glands (ie, the parotid, the submandibular, and the sublingual) and a number of minor glands found in the mucosa of the upper aerodigestive tract. Lesions may be inflammatory or obstructive in nature or may stem from granulomatous or neoplastic disease. As such, establishing a definitive diagnosis is often quite challenging. This article reviews widely used diagnostic approaches and briefly describes various salivary gland lesions within an etiologic framework.

Tuberculous parotitis: case report and literature review.

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.

Tuberculous osteomyelitis of the mandible: a case report.

Osteomyelitis of jaws caused by infection with Mycobacterium tuberculosis is uncommon, especially in children. We present a case of tuberculous osteomyelitis in a young child. Its clinical presentation, with features similar to a dento-alveolar abscess, underline the importance of considering it in the differential diagnosis of jaw lesions. We discuss of the diagnostic techniques, management and preventive measures, and stress the importance of history taking during clinical examination.

Benign salivary gland disease.

The majority of benign clinical problems that present affect the major salivary glands--parotid and submandibular. However, there are numerous minor salivary glands located in the mucosa of the head and neck which have the same predilection to the same diseases that affect the major glands but to a lesser frequency.

Mycobacterial disease of the parotid gland.

Mycobacterial disease is an unusual but important condition that should be considered in the differential diagnosis of a discrete parotid gland swelling or mass. The management of this condition involves exclusion of neoplastic disease and combined medical and surgical therapy. We present 5 cases of mycobacterial involvement of the parotid gland and discuss issues surrounding the diagnosis and treatment options.

Primary mycobacterial infection of the uvula.

Tuberculosis, and non-tuberculous mycobacterial infections are becoming more common thus it is more likely that otolaryngologists will encounter these conditions. We describe an otherwise well patient, with symptoms and signs from chronic uvular inflammation, who proved to have a primary mycobacterial infection. This is an unique presentation in the literature and reminds clinicians of the need, where uncertainty exists in diagnosis, to consider mycobacterial infections.

Facial paralysis due to primary tuberculosis of the parotid gland.

An 11-year-old girl presented with parotid mass and facial paralysis due to primary TB of the parotis gland. The diagnosis was made only postoperatively, by histology, and microscopic examination for acid and alcohol fast bacilli.

[Submandibular and laterocervical adenopathies of tubercular origin; aspects of 8 cases of cervical adenopathies of tubercular origin]. / Le adenopatie sottomandibolari e laterocervicali di origine tubercolare; considerazioni su otto casi di adenopatie cervicali di origine tubercolare.

The Authors illustrate 8 cases of submandibular and latero-cervical adenopathies of tubercular origin. They deal with the subject from the etiopathogenic and clinical point of view. In particular they consider the epidemiological incidence and the advantages of surgical treatment in comparison with medical therapy.