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 tumour. 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 2 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 extrapulmonary tuberculosis.