Published: 2018-03-21

Primary tubercular submandibular abscess: a rare presentation in two years old girl

Jyoti Bajpai, Surya Kant, Ajay Kumar Verma, Darshan Kumar Bajaj, Akshyaya Pradhan


Extra pulmonary tuberculosis (TB) continues to be a serious problem in developing countries. The prevalence of extra pulmonary tuberculosis (EPTB) is higher in immunocompromised, especially human immunodeficiency virus (HIV) co-infected patients. The most common site of extra pulmonary tuberculosis is lymph node followed by pleura. Lymph nodes are pivotal component of immune system and hence they are affected in various conditions like infections, autoimmune disorder, malignancy However, tubercular affliction of submandibular lymph node is not common. Only a few cases of tubercular submandibular abscess in immune-competent children have been reported in literature. Here we report a case of two-year old girl with non-healing multiple submandibular lymph node abscess presenting as a primary tuberculosis that proved diagnostically challenging. She responded favourably to a five drug anti-tubercular regimen.


Immunocompetent, Line probe assay, Mycobacterium tuberculosis, Primary tuberculosis, Submandibular lymphadenopathy

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WHO. Global Tuberculosis Control 2015, Geneva, 2015. Available at: global_report. Accessed January 2017.

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120:316-53.

Ozvaran MK, Baran R, Tor M, Dilek I, Demiryontar D, Arinc S. Extrapulmonary tuberculosis in non-human immunodeficiency virus infected adults in an endemic region, Annals of Thoracic medicine. 2007;3(2):118-21.

FitzGerald JM, Houston S. Tuberculosis: The disease in association with HIV infection. CMAJ. 1999;161:47-51.

Fontanilla JM, Barnes A, von Reyn CF. Current Diagnosis and management of peripheral tubercular lymphadenitis. Clin Infect Dis. 2011;53:555.

Corbett EL, Watt CJ, Walker N. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med. 2003;163:1009-21.

Aaron L, Saadoun D, Calatroni I. Tuberculosis in HIV-infected patients: a comprehensive review. Clin Microbiol Infect. 2004;10:388-98.

Dandapat MC. Peripheral lymph node tuberculosis: a review of 80 cases. Br J Surg. 1990;77(8):911.

Thompson MM, Underwood MJ, Sayers RD, Dookeran KA, Bell PR. Peripheral tuberculous lymphadenopathy: A review of 67 cases. Br J Surg. 1992;79(8):763-4.

Popowich L, Heydt S. Tuberculous cervical lymphadenitis. J Oral Maxillofac Surg. 1982;40:522-4.

Dimitrakopoulos I, Zouloumis L, Lazaridis N, Karakasis D, Trigonidis G, Sichletidis L. Primary tuberculosis of the oral cavity. Oral Surg Oral Med Oral Pathol. 1991;72(6):712-5.

Hock-Liew E, Shin-Yu L, Chuang-Hwa Y, Wei-Jen C. Oral tuberculosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:415-20.

Bruzgielewicz A, Rzepakowska A, Osuch-Wojcikewicz E. Tuberculosis of the head and neck–epidemiological and clinical presentation. Arch Med Sci. 2013;346.

Maurya AK, Nag VL, Kant S, Kushwaha RAS, Kumar M, Singh A.K, et al. Prevalence of Nontuberculous Mycobacteria among Extrapulmonary Tuberculosis Cases in Tertiary Care Centers in Northern India. Bio Med Research International. 2015;2015.

Ito FA, de Andrade CR, Vargas PA, Jorge J, Lopes MA. Primary tuberculosis of the oral cavity. Oral Dis. 2005;11:50-3.