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一名幼儿的腮腺结核导致蚕食性下颌骨骨髓炎:难以捉摸的诊断。

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

作者信息

Kaushal Darwin, Sharma Vidhu, Kumar Prawin, Elhence Poonam

机构信息

Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

出版信息

Sudan J Paediatr. 2019;19(2):156-160. doi: 10.24911/SJP.106-1549807009.

Abstract

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.

摘要

结核病可累及身体几乎任何器官,并具有不寻常的表现。我们在此报告一例3岁儿童腮腺结核导致下颌骨骨髓炎的病例,该患儿自4个月前以来一直出现左侧面部肿胀。患儿曾在其他地方因疑似腮腺脓肿接受反复切开引流。初步检查结果不明确。影像学检查显示左侧腮腺有一个异质性肿块病变,下颌骨相邻升支广泛破坏,提示为牙源性肿瘤。左侧腮腺活检最终确诊为结核脓肿。该患儿对抗结核治疗反应良好。本病例强调了全面检查的重要性,包括活检,以避免不必要的手术干预。

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本文引用的文献

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Tuberculous parotitis: case report and literature review.
Ann Otol Rhinol Laryngol. 2005 Jul;114(7):547-51. doi: 10.1177/000348940511400710.
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Tuberculosis of the parotid gland.
J Laryngol Otol. 2005 Apr;119(4):311-3. doi: 10.1258/0022215054020494.
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Extrapulmonary tuberculosis.肺外结核
Indian J Med Res. 2004 Oct;120(4):316-53.

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