Re: Rapid diagnosis and successful drug therapy of primary parotid tuberculosis in the pediatric age group: a case report and brief review of the literature

We read with great interest the article entitled ‘‘Rapid diagnosis and successful drug therapy of primary parotid tuberculosis in the pediatric age group: a case report and brief review of the literature’’ by Nag et al. They have described a rare case of parotid tuberculosis in a pediatric patient with a review of the literature. We would like to report a similar case of parotid tubercular abscess in a 14-year-old female. We would also like to highlight the role of imaging and ultrasound-guided aspiration in diagnosis. The preoperative diagnosis of tuberculosis helps to avoid unnecessary surgery. A 14-year-old female presented with a progressively increasing swelling in the left parotid region of two-month duration. There was no relationship of swelling to meals. Swelling was not associated with any other symptoms. Her past history and family history was insignificant. Physical examination revealed a 3 3 cm mobile, cystic, non-tender mass occupying the superficial lobe of the left parotid gland. The overlying skin was normal. The complete blood count, erythrocyte sedimentation rate, other biochemical investigations, and chest radiograph were normal. Ultrasound examination revealed a well-defined, unilocular, anechoic lesion with mobile internal debris involving the superficial lobe of the left parotid gland. Magnetic resonance imaging showed a well-defined 3 3 cm mass lesion involving the left parotid gland. The lesion was hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging with peripheral rim enhancement (Figure 1). An intra-parotid node was also seen involving the superficial lobe of the left gland showing peripheral rim enhancement. The differential diagnosis included [(Figure_1)TD$FIG]