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Tuberculous Lymphadenitis and Parotitis

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  • Authors: Juan Carlos Cataño1, Jaime Robledo2
  • Editor: David Schlossberg3
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Section of Infectious Diseases, University of Antioquia Medical School, Medellín, Colombia; 2: Section of Mycobacteria Research, Corporación para Investigaciones Biológicas and Universidad Pontificia Bolivariana, Medellín, Colombia; 3: Philadelphia Health Department, Philadelphia, PA
  • Source: microbiolspec November 2016 vol. 4 no. 6 doi:10.1128/microbiolspec.TNMI7-0008-2016
  • Received 23 September 2016 Accepted 14 October 2016 Published 23 November 2016
  • Juan Carlos Cataño, kataju@hotmail.com
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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.

  • Citation: Cataño J, Robledo J. 2016. Tuberculous Lymphadenitis and Parotitis. Microbiol Spectrum 4(6):TNMI7-0008-2016. doi:10.1128/microbiolspec.TNMI7-0008-2016.

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2016-11-23
2017-11-23

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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Figures

Image of FIGURE 1
FIGURE 1

Multiple cervical lymphadenopathy in a patient with TB lymphadenitis. Computed tomography showing diffuse lymphadenopathy in cervical chains.

Source: microbiolspec November 2016 vol. 4 no. 6 doi:10.1128/microbiolspec.TNMI7-0008-2016
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Image of FIGURE 2
FIGURE 2

Cervical scrofula. Sternal scrofula. Reprinted from reference 106 , with permission.

Source: microbiolspec November 2016 vol. 4 no. 6 doi:10.1128/microbiolspec.TNMI7-0008-2016
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Image of FIGURE 3
FIGURE 3

Endoscopy with esophageal fistula from esophagus to mediastinum. Contrasted chest computed tomography with a fistula from esophagus to mediastinum. Reprinted from reference 107 , with permission.

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