# Tuberculous Lymphadenitis in Children: A Coincidental Diagnosis—A Case Report

## TL;DR

A child's neck swelling was initially thought to be a dental infection but was later diagnosed as tuberculosis, highlighting the need for thorough evaluation in similar cases.

## Contribution

This case report emphasizes the importance of considering tuberculosis in children with cervicofacial swellings to avoid misdiagnosis.

## Key findings

- A 10-year-old boy's lower mandibular swelling was diagnosed as cervical tuberculous lymphadenitis after initial misdiagnosis as dental cellulitis.
- The case highlights the diagnostic challenge of asymptomatic tuberculosis in children and the role of dentists in early detection.
- A multidisciplinary approach including clinical, radiological, and histopathological assessments is crucial for accurate diagnosis.

## Abstract

The discovery of a cervicofacial swelling is a common concern among the pediatric population with a broad range of potential diagnoses. While infectious origins related to dental infection are frequent, it is crucial not to overlook other systemic causes. Among these causes, cervical tuberculous lymphadenitis (CTL) stands out as one of the most common forms of extrapulmonary tuberculosis. This condition poses a significant diagnostic challenge in children, as it is often asymptomatic and can lead to a misdiagnosis.

The aim of this paper is to highlight, through a case report, the diagnostic approach to a lower mandibular swelling in a 10-year-old boy initially diagnosed as cellulitis of dental origin. However, further investigation revealed CTL, confirmed by lymph node biopsy, leading to a 6-month regimen of four drugs for treatment. This uncommon presentation emphasizes the importance of thorough investigation, as the overlap in symptoms with dental infection could potentially lead to misdiagnosis. Dentists can play a crucial role in detecting tuberculosis in cases of cervicofacial swelling. By doing so, they can ensure early diagnosis and promptly refer the patient for appropriate management.

The case report underscores the importance of considering tuberculosis in the differential diagnoses of cervicofacial swellings in children, emphasizing comprehensive clinical, radiological, and histopathological assessment for accurate diagnosis and effective treatment.