%0 Journal Article %T Primary tubercular sialadenitis – A diagnostic dilemma %J Iranian Journal of Otorhinolaryngology %I Mashhad University of Medical Sciences (MUMS) %Z 2251-7251 %A Virmani, Nitish %A Dabholkar, Jyoti %D 2019 %\ 01/01/2019 %V 31 %N 1 %P 45-50 %! Primary tubercular sialadenitis – A diagnostic dilemma %K Parotid gland %K Sialadenitis %K Tuberculosis %K submandibular gland %K Salivary gland calculi %K Salivary fistula %R 10.22038/ijorl.2018.32584.2073 %X Introduction: Involvement of the salivary glands in tuberculosis is rare, even in countries where tuberculosis is endemic. It can occur by systemic dissemination from a distant focus or, less commonly, as primary involvement. This article focuses on its myriad clinical presentations that pose a diagnostic challenge to the clinician. We discuss the schema of investigations required to confirm the diagnosis and the limitations faced in the low-cost setting of a developing country.   Materials and Methods: Medical records, including history, physical examination and imaging findings, and the results of cytological, microbiological and histopathological studies of patients diagnosed with primary tubercular sialadenitis were retrieved and analyzed. Results: Seven patients were treated over a 2-year period. The most common mode of presentation was a painless mass of the involved gland in four patients. One patient each presented with chronic non-obstructive sialadenitis, sialolithiasis, and acute suppurative sialadenitis. Fine needle aspiration cytology was diagnostic in five out of seven cases (71.4%), while mycobacterial culture was positive in two patients (28.6%). In one patient, a diagnosis could only be reached on histopathological examination of the resected gland. Conclusion: We recommend cytology studies, acid-fast bacilli staining, and mycobacterial culture as the initial investigation on the aspirate in suspected patients, while polymerase chain reaction should be reserved for negative cases. A high index of suspicion, early diagnosis, and timely institution of anti-tuberculosis treatment is essential for establishing cure. The role of surgery in diagnosed cases of tuberculosis is limited. %U https://ijorl.mums.ac.ir/article_12119_ca9d2d883c98e49cf142dd7a2c9252c7.pdf