Granulomatous infection of parotid gland and its subcutaneous tissue by Mycobacterium abscessus subspecies massiliense in a 3-year-old child

Acid fast bacilli positive granulomatous infections by non-tubrerculous mycobacteria are often misdiagnosed as tuberculosis. We present a case of parotid gland infection and abscess in the subcutaneous tissue over the gland which was suspected as tuberculosis by ultrasonogram and histopathology examinations. Mycobacterium abscessus subspecies massiliense was isolated and identified. In addition to the severe pulmonary infections, M. abscessus organism sometimes produces granulomatous reaction in extra pulmonary sites as the conventional anti tuber-culous treatment is not useful, the correct identification is crucial for optimum management.