Saturday, 26 December 2015

CASE 355: PAROTID GLANDS TUBERCULOSIS, Dr LÊ ĐÌNH VĨNH PHÚC, MEDIC MEDICAL CENTER, HO CHI MINH CITY, VIETNAM


A female 19 yo patient, student, swelling and pain in the parotid glands about a week, not fever.


Ultrasonography showed multiple structures within the parotid glands on 2 sides, hypoechoic, well-defined, measuring approximately 5 - 12 mm, with the umbilical node. She was diagnosed inflammation of the parotid glands and antibiotics for ten days  (cephalosporin 3 and fluoroquinolon).


But parotid glands swelling continuosly, ultrasound images  with more nodules in the parotid glands,and antibiotics for ten days again. In next follow-up visit parotid glands biopsy was done, and result showed chronic salivary gland inflammation.
Patient was sent to hospitalization Ho Chi Minh city in dentomaxillofacial center for 2 weeks of antibiotics as Sjogren syndrome. Parotid glands still  swollen and had discharge line to detect skin.  And she returned to MEDIC for parotid gland ultrasound.

Ultrasound image showed multiple hypoechoic structures with fluid inside, well-defined, proliferative vascular supplying, created road detect skin.

MSCT with CE showed parotid gland hypertrophy, having multiple lesions with fluid density in the central area.



Parotid gland biopsy showed salivary gland with Langhans great cells.


Parotid gland fluid examination showed high ADA and PCR/ TB (+).



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