Tuesday 7 June 2011

How to Diagnose and Manage this Case?



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Dr.Pookamala, Chennai

TB of Submandibular node/ gland,

"Initial investigations:
hemogram with ESR, Blood sugar, Mantoux,discharge for gram staining, fungal staining and C&S
Biopsy of sinus margin with skin and base of sinus.
X-ray -Panorex (Mandible)
Second line investigations:
Usg neck
sinogram
Discharge-TB Culture
Tissue sample for TB-PCR
CT-Sinogram."

Differential diagnosis:
Atypical Tuberculosis(Scrofuloderma),Osteomyelitis of mandible, calculus sialadenitis with Orocutaneous fistula, cervical actinomycosis.

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