Tuberculous parotitis

an uncommon presentation of a reemerging disease

Abstract

Introduction: according to the World Health Organization (WHO), Childhood tuberculosis (TB) occurs in children under 15 years of age. An increase in the incidence of this disease was detected in children in recent years.  The diagnosis of childhood TB is a challenge because of its non-specific clinical manifestations.

Objective: describe a case of a child with tuberculous parotitis.

Case report: 5-year-old healthy male living with 2 adults with pulmonary TB under treatment. Vaccination according to his age.  Consultation regarding a neck tumor of 3 days of evolution, patient showed weight loss and no history of fever. Diagnosis at admission was cervical adenitis probably with bacterial etiology. Antibiotic treatment, poor evolution, fever persisted and tumor size remained unchanged. Soft tissue ultrasound: enlarged right parotid gland. Tuberculin test: 14mm.  Erythrosedimentation rate 75mm / h. With a parotid tuberculosis approach, we performed a gland puncture and obtained purulent material. The infection was bacteriologically confirmed by molecular methods and culture. Treatment for tuberculosis began. Patient received treatment for 9 months and showed complete resolution and no complications.

Conclusions: although tuberculosis is a reemerging disease and extra-pulmonary presentation forms are more frequent in children than in adults, diagnosis remains a challenge. It is essential to remember that the TB diagnosis in children usually shows a sentinel health event of recent transmission from a bacilliferous adult who usually lives with the child and must be properly diagnosed and treated.