A cervical tuberculous abscess mimicking a fourth branchial cleft cyst in a child: PCR, the key to fast diagnosis

Background Anterior cervical tuberculous abscess is a rare presentation of extrapulmonary tuberculosis even in endemic countries. Case presentation We report a case of a 14-year-old girl with a 5 day history of an anterior mass. The diagnosis of an infected fourth branchial cleft cyst was first evoked. Fine-needle aspiration cytology was suggestive of tuberculosis. Polymerase chain reaction analysis was the key to the diagnosis of a tuberculous abscess. Conclusions In endemic countries, abscesses occurring in uncommon sites should be dealt with a high degree of suspicion for tuberculosis. Early diagnosis is essential to initiate specific and effective treatment. Pre-operative diagnosis avoids invasive surgery and related complications.