Unusual association of primary parotid and conjunctival tuberculosis in a young immunocompetent patient: A case report
This article has been Reviewed by the following groups
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
2. Abstract Extrapulmonary tuberculosis often presents as lymphadenitis. In the head and neck area, tuberculous involvement of the parotid gland is rare and challenging to diagnose due to non specific symptoms, which can be confused with a tumor. Tuberculous conjunctivitis, although uncommon, should be considered in cases of chronic, treatment-resistant conjunctivitis. The association of primary parotid and conjunctival tuberculosis is exceptional. They are difficult to diagnose due to the non-specificity of their clinical, biological and radiological signs. We report the case of a 24-year-old immunocompetent patient with no history of tuberculosis, who presented with intermittent swelling of the left parotid gland, accompanied by unilateral redness of the eye, which appeared two months later, in a context of fever and night sweats. The patient also reported a foreign body sensation in his eye, mild tearing, and photophobia . Clinical examination revealed painful, warm swelling of the left parotid gland, as well as localized granulomatous conjunctivitis. Cervico-parotid CT and MRI revealed two well-limited, oval, left parotid formations with a slightly thickened and enhanced wall after injection of Gadolinium, suggestive a priori of abscessed collections. The diagnosis of primary parotid and conjunctival tuberculosis was made on the basis of histological examination of the biopsies, as well as direct examination, culture and GeneXpert. The patient progressed well on anti-bacillary treatment. Our work underlines the great importance of GeneXpert, which is a rapid and highly sensitive technique, effective in the diagnosis of extra pulmonary tuberculosis.
Article activity feed
-
I am pleased to tell you that your article has now been accepted for publication in Access Microbiology.
-
-
Comments to Author
The manuscript presents a case report on parotid TB and the use of GeneXpert for its diagnosis. There are minor amendments recommended to strengthen the presentation of this work. Can the authors provide information on any underlying health conditions of this patient, medications taken, details of serological examinations? The discussion can be strengthened by including recent studies on parotid TB diagnosis. Could the authors provide discussion on the prevalence of other cases of parotid TB, and the likely routes of infection, given there are no signs of pulmonary TB. The conclusion section does not include the importance on the use of GeneXpert for diagnosis of parotid TB.
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
To …
Comments to Author
The manuscript presents a case report on parotid TB and the use of GeneXpert for its diagnosis. There are minor amendments recommended to strengthen the presentation of this work. Can the authors provide information on any underlying health conditions of this patient, medications taken, details of serological examinations? The discussion can be strengthened by including recent studies on parotid TB diagnosis. Could the authors provide discussion on the prevalence of other cases of parotid TB, and the likely routes of infection, given there are no signs of pulmonary TB. The conclusion section does not include the importance on the use of GeneXpert for diagnosis of parotid TB.
Please rate the quality of the presentation and structure of the manuscript
Satisfactory
To what extent are the conclusions supported by the data?
Partially support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
-
This study would be a valuable contribution to the existing literature. The reviewers were largely positive about the manuscript and have highlighted minor concerns with the work presented. Please ensure that you address their comments.
-
Comments to Author
It was a nice case report that will add to the literature and knowledge of the spectrum of extrapulmonary TB. A few modifications though needed, Line 66- kindly correct the spelling as Ziehl-Neelsen (ZN) stain and Löwenstein-Jensen (LJ) medium. Line no-68, the principle of the Xpert MTB/RIF test is an automated in vitro diagnostic test using nested real-time PCR for the qualitative detection of MTB-complex and RIF resistance. The primers in this test amplify a portion of the rpoB gene containing the 81 base pair core region. The probes are designed to differentiate between the conserved wild type sequence and mutations in the core region that are associated with RIF resistance. Line 84- elaborate on the characteristics of inflammatory response. Line 85- mention the dimensions of fluctuating mass Line …
Comments to Author
It was a nice case report that will add to the literature and knowledge of the spectrum of extrapulmonary TB. A few modifications though needed, Line 66- kindly correct the spelling as Ziehl-Neelsen (ZN) stain and Löwenstein-Jensen (LJ) medium. Line no-68, the principle of the Xpert MTB/RIF test is an automated in vitro diagnostic test using nested real-time PCR for the qualitative detection of MTB-complex and RIF resistance. The primers in this test amplify a portion of the rpoB gene containing the 81 base pair core region. The probes are designed to differentiate between the conserved wild type sequence and mutations in the core region that are associated with RIF resistance. Line 84- elaborate on the characteristics of inflammatory response. Line 85- mention the dimensions of fluctuating mass Line 102 - correctly write hepatitis B, C & HIV Line 101-105- make it one paragraph Line 112- write the full form of ANC Line 117- no need to repeat the macroscopic appearance as already written before Line 119- is there any significance in mentioning 1 and 10 bacilli per 300 fields in EPTB samples? Line 121 to 140 - make it to one paragraph Line 143- give reference to the treatment protocol followed Line 175- change the reference no-4 with a recent study reference. NOTE: It would be better if the authors could include references from recent literatures , preferably in the last 5 yrs or maximum 10 years. Line 187- replace 30 and 40 with 30-40 years Line 192-199- make it one paragraph Line 232-233- mention the author's name and place of study Line 243- delete "all the more"
Please rate the quality of the presentation and structure of the manuscript
Good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
-