Vol.98 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 98 No. 5 May 2005
A Case of Tuberculous Parotitis
Yohji Asama and Fumiyuki Goto
(Hino Municipal Hospital, University of Keio)
We report a case of tuberculous parotitis following acute tonsillitis. A 30-year-old female was admitted to our hospital because of sore throat, right subauricular swelling, fever, and headache. Initial CT examination demonstrated inflammatory changes in the right parotid gland and bilateral tonsils. She was discharged after intensive antibiotics therapy. Two weeks later swelling of the right parotid gland recurred. The second CT examination demonstrated abscess of the right parotid gland and adjacent lymph node swelling. Intensive antibiotics therapy had no significant effect. We performed surgical drainage of the parotid gland and biopsy of the lymph node. The specimen showed milliary abscess together with giant cells which were quite similar to Langerhans cell. Although Ziehl-Neelsen straining of the specimen and PCR of the discharge did not disclose any acid-fast bacilli, we speculated that tuberculosis infection was present. Therefore, we performed tuberculin skin test, which showed an intense positive reaction. The patient had a history of medical work in which she came in close contact with tuberculosis patients. Antimycobacterial therapy was started based only on these clinical manifestations. All of the clinical symptom disappeared. We report the difficulty in diagnosing tuberculosis of the parotid gland.
Key words : tuberculosis, parotitis, tonsillitis