Tuberculosis lymphadenitis: An unusual swelling of salivary glands, a case series study in Iran

Tuberculosis is a chronic granulomatous infection and has become a global concern. This disease is caused by Mycobacterium tuberculosis, but other types of Mycobacterium can also cause the disease. Tuberculosis usually affects the respiratory system, but other organs, called extrapulmonary tuberculosis, can be involved. Lymph node tuberculosis is one of the manifestations of extrapulmonary tuberculosis, especially in regions where tuberculosis is endemic. The involvement of salivary glands with tuberculosis is an uncommon condition. Here we present three cases (two adults and one child) with tuberculosis salivary gland lymphadenitis.

In all the cases, tuberculosis diagnosis was confirmed by biopsy. Although, the diagnosis of tuberculosis was easier in the child due to symptoms like night sweating and fever and positive purified protein derivative test, in adults, there were no abnormalities in the initial laboratory tests, and purified protein derivative tests were negative, which made the diagnosis of tuberculosis more complicated. Although, salivary gland involvement with tuberculosis is not common, it should be considered a differential diagnosis in patients with swelling of salivary glands. In addition, the diagnosis confirmation should be based on biopsy, and normal laboratory tests and negative purified protein derivative tests should not confuse us. An early diagnosis is essential, and early initiation of an anti-tuberculosis regimen can prevent the following complications.