A Retrospective Cohort Study of Major Salivary Gland Tuberculosis: Our 13 Year Experience.

The tuberculous infection of major salivary glands is rare because they are relatively resistant to tubercle bacilli. The aim of this study is to present our 13 year experience on major salivary gland tuberculosis. The clinical, histopathological, microbiological and imaging records of 9 cases of major salivary gland tuberculosis were reviewed retrospectively. The cases diagnosed with either microbiological culture and/or polymerase chain reaction assay and/or Histopathological examination were included in the study. Descriptive statistics were used to summarize the data. There were 9 cases with tuberculous involvement of major salivary glands; parotid (n = 5), submandibular (n = 3), sublingual (n = 1). The most common local symptom was painless swelling present in 8 cases and constitutional symptoms were present in all the cases. The previous history of TB was present in 5 out of 9 cases. Surgical intervention was done in 2 cases of parotid TB for diagnostic purpose and therapeutic intervention was required in 1 patient. Patients responded well to medical therapy. Two patients with disseminated disease died. The major salivary gland is rare in both immunocompetent and immunocompromised patients. Diagnosis is difficult and requires high degree of suspicion especially in isolated cases. Medical management yields satisfactory results.

Submandibular Gland Tuberculosis: A Literature Review and Update.

Submandibular salivary gland is an uncommon and unusual site for tuberculosis. It is a rare extrapulmonary manifestation of a common infection caused by Mycobacterium tubercle bacillus. Submandibular gland TB can be due to primary or secondary infection. The clinical features are non-specific and depend on its manifestations. A delay in diagnosis is common because of the rarity of disease. Direct histological examination is the best method of diagnosis. As the disease is curable with antituberculous drugs; treatment should not be withheld in suspected cases until the diagnosis is confirmed. Surgery is indicated for non-responsive disease and complications. Till date, only 15 cases have been reported in the literature. First case was reported in the year 1990. The authors encountered three cases in last 10 years. The aims of this study are to review clinical presentation, epidemiological features, diagnostic methods and to provide our data and guidelines for optimum management of this rare pathology.