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Multiple strains of Mycobacteria cause tuberculosis (TB), a chronic, specific infectious granulomatous disease. It mainly occurs with pulmonary involvement when compared to extrapulmonary involvement. Primary oral occurrence is uncommon and oral lesions are usually secondary to pulmonary involvement. When there are no active pulmonary clinical manifestations of TB, the diagnosis of the very rare entity of primary gingival TB poses a great challenge to clinicians. In this case report, we discuss a case of primary gingival TB in a 24-year-old lactating mother. This article briefs the onset and course of the lesion during pregnancy and postpartum, elaborates the pathway to diagnosis, various investigations performed and the regimen of antitubercular therapy for 6 months, followed by complete resolution of the lesion without recurrence. This report also describes the significance of considering TB as a differential diagnosis in oral lesions and the various diagnostic methods available. It also emphasizes the sole importance of histopathology in the early detection of the lesion and its management.

Tuberculosis is a chronic granulomatous transmitting type of disease caused by the Mycobacterium tuberculosis complex. It can affect any part of the body, including the oral cavity. Oral tuberculosis can be primary or secondary, In oral cavity, tongue, buccal mucosa, lip, and palate may involve. Here, the authors present a case of a 50-year-old male patient of tuberculosis of palate, manifesting as a non healing ulcer. The ulcer was present in the middle part of the palate, having undermined edge and a non indurated margin. Though it was tender on palpation, there was no evidence of palatal perforation or bony erosion on radiographic examination. A chest radiograph revealed consolidation in the apex and right upper zone, and Cartridge Based Nucleic Acid Amplification Test (CBNAAT) of sputum was positive, but biopsy of the lesion could not be performed because of problem in patient’s consent. The authors took a chance and started antitubercular drugs. They observed the changes of ulcer at regular intervals. No topical medication was given for the ulcer. After taking antitubercular drugs, the condition improved rapidly and The ulcer healed completely after completing the Intensive Phase (IP) only. Tuberculosis is a transmitting and fatal disease. Early diagnosis with proper treatment can prevent complications and the transmission of the disease to others.

Tuberculosis is a chronic granulomatous transmitting type of disease caused by the Mycobacterium tuberculosis complex. It can affect any part of the body, including the oral cavity. Oral tuberculosis can be primary or secondary, In oral cavity, tongue, buccal mucosa, lip, and palate may involve. Here, the authors present a case of a 50-year-old male patient of tuberculosis of palate, manifesting as a non healing ulcer. The ulcer was present in the middle part of the palate, having undermined edge and a non indurated margin. Though it was tender on palpation, there was no evidence of palatal perforation or bony erosion on radiographic examination. A chest radiograph revealed consolidation in the apex and right upper zone, and Cartridge Based Nucleic Acid Amplification Test (CBNAAT) of sputum was positive, but biopsy of the lesion could not be performed because of problem in patient's consent. The authors took a chance and started antitubercular drugs. They observed the changes of ulcer at regular intervals. No topical medication was given for the ulcer. After taking antitubercular drugs, the condition improved rapidly and The ulcer healed completely after completing the Intensive Phase (IP) only. Tuberculosis is a transmitting and fatal disease. Early diagnosis with proper treatment can prevent complications and the transmission of the disease to others. [ABSTRACT FROM AUTHOR]

Multiple strains of Mycobacteria cause tuberculosis (TB), a chronic, specific infectious granulomatous disease. It mainly occurs with pulmonary involvement when compared to extrapulmonary involvement. Primary oral occurrence is uncommon and oral lesions are usually secondary to pulmonary involvement. When there are no active pulmonary clinical manifestations of TB, the diagnosis of the very rare entity of primary gingival TB poses a great challenge to clinicians. In this case report, we discuss a case of primary gingival TB in a 24‑year‑old lactating mother. This article briefs the onset and course of the lesion during pregnancy and postpartum, elaborates the pathway to diagnosis, various investigations performed and the regimen of antitubercular therapy for 6 months, followed by complete resolution of the lesion without recurrence. This report also describes the significance of considering TB as a differential diagnosis in oral lesions and the various diagnostic methods available. It also emphasizes the sole importance of histopathology in the early detection of the lesion and its management. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to analyze the demographic, clinical, histopathological, diagnosis, treatment, and follow‐up data on the occurrence of oral and maxillofacial tuberculosis (OMTB). Methods: Electronic searches without publication date restrictions were undertaken in four databases. Case reports and case series describing the occurrence of OMTB were included. Critical evaluation of studies was done using the Joanna Briggs Institute – University of Adelaide tool for case reports or case series. Results: A total of 217 studies were included in the qualitative synthesis, for a total of 301 cases of OMTB. Of these patients, 192 (63.7%) were male, with an average age of 39.6 ± 19.8 (15 months to 81 years). The tongue (n = 80/26.6%) represented the most common affected site, followed by the mandible (n = 43/14.3%). The clinical presentation consisted mainly of a painful ulcerated lesion (n = 156/56.5%). Histopathological analysis showed a granulomatous inflammation in most cases (n = 156/63.1%). The main diagnostic methods used were sputum test (n = 53/26.8%), culture (n = 49/24.7%) and purified protein derivative (PPD), or Mantoux test (n = 49/24.7%). Antituberculosis therapy was used in 244 cases (100.0%) and 5.2% of patients died. Conclusions: This systematic review provided clinical, demographic data and information about diagnostic methods of OMTB lesions and served as an important guide to assist health professionals in the early diagnosis of these lesions. [ABSTRACT FROM AUTHOR]

Background: Maxillofacial tuberculosis is a diagnostic challenge for surgeons. The aim of this study was to present a detailed analysis of Xpert test in diagnosing maxillofacial tuberculosis and to analyse the accuracy of Xpert test results for various tissues of maxillofacial region. Materials and Methods: In this cross-sectional study, patients were selected randomly from outpatient department. The patients who had clinical picture and differential diagnosis highly suggestive of maxillofacial tuberculosis were included. Patients were divided into three different groups depending upon the site of involvement. The samples collected from the patients were further subdivided depending upon the type of specimen. Patients were screened first by routine tests, and the negative cases were followed by Xpert test for tuberculosis. Results: A total of 54 patients were enrolled in the study, 13 patients were found to be positive for maxillofacial tuberculosis on routine screening tests for tuberculosis, and 41 tested negative on routine test and were evaluated further through Xpert test. Specimens from bone (n12), soft tissue and skin biopsy (n15) and aspirates from lymph nodes (n14) were obtained and tested. Twenty-one samples were found to be positive, and 20 were negative upon Xpert testing. There was a statistically significant difference seen between the test groups (p < 0.01) with higher frequency of negative results in routine test. The p value for various specimens containing pus, biopsies and aspirates was 0.045, 0.023 and 0.067, respectively. Conclusion: Xpert test is more accurate when compared to routine test for diagnosing maxillofacial tuberculosis. Although accuracy of Xpert test is better for pus and biopsy samples in the specimens from bone and soft tissue, it gives poor accuracy for aspirated cells. The aspirates from lymph nodes were more susceptible for false negative test. [ABSTRACT FROM AUTHOR]

Adela-Ioana Mocanu,1,&ast; Horia Mocanu,2 Cosmin Moldovan,3,4,&ast; Ioana Soare,3,&ast; Elena Niculet,5,6 Alin Laurentiu Tatu,6,7,&ast; Claudiu Ionut Vasile,7,&ast; Daniela Diculencu,8 Paraschiva A Postolache,9,&ast; Alexandru Nechifor7 1Department of ENT & HNS, Polimed Medical Center, Bucharest, Romania; 2Department of ENT & HNS, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, Romania; 3Faculty of Medicine, “Titu Maiorescu” University of Bucharest, Bucharest, Romania; 4General Surgery Ward, ‘Witting’ Clinical Hospital, Bucharest, Romania; 5Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dun&abreve;rea de Jos” University, Galati, Romania; 6Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dun&abreve;rea de Jos” University, Galați, Romania; 7Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dun&abreve;rea de Jos” University, Galati, Romania; 8Medical Analysis Laboratory, Clinical Pneumoftisiology Hospital, Iasi, Romania; 9Clinical Medical Department, Faculty of Medicine, “Grigore T Popa” University of Medicine and Pharmacy, Iasi, Romania&ast;These authors contributed equally to this workCorrespondence: Adela-Ioana Mocanu, Department of ENT&HNS, Polimed Medical Center, Bucharest, Romania, Tel +40 751 209 060, Email adela.ioana.mocanu@gmail.com Elena Niculet, Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dun&abreve;rea de Jos” University, Galați, Romania, Tel +40 741 398 895, Email helena_badiu@yahoo.comAbstract: Tuberculosis is a disease of global outreach that may affect the entire human body but is most commonly located in the lungs. Otorhinolaryngological manifestations of tuberculosis are rare, mostly occurring secondary to pulmonary disease but nevertheless represent significant diagnostic challenges. Nasopharyngeal tuberculosis is rare, representing around 1% of all upper air-way localizations and the most common presentation is in the form of adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. We present four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid occurrence of complications.Keywords: case report, tuberculosis, nasopharynx, oral tuberculosis, head and neck, extra nodal

Introduction: Tuberculosis mostly affects the lungs, but may also affect the central nervous system, lymphatic system, circulatory system, genitourinary system, bones, joints, and skin. Extrapulmonary involvement in tuberculosis is rare, accounting for just 10 to 15% of cases. The lymph nodes are the second most common site of tuberculosis infection. Oral tuberculosis has long been thought to be an unusual phenomenon. Oral manifestations are thought to occur in just 0.05 to 5% of all tuberculosis cases. Surface ulcers, patches, papillomatous lesions, and indurated soft tissue lesions are the most common oral manifestations. Case Presentation: A 69-year-old man presented to the Department of Ear, Nose, Throat at MGM Hospital in Aurangabad, India, with a painful ulcer and tiny nodules on the tongue’s tip and lateral surface. The ulcer appeared 3–4 weeks ago without any obvious trigger with a prickling feeling and increased soreness over the area., Onintraoral inspection multiple small nodules is measuring about 0.1 cm and multiple circular ulcer measuring about 0.2 x 0.1 cm in diameter at the tip and lateral border of the tongue. A granulomatous center and a whitish, well-defined border with mild elevation characterized the ulcer. Conclusion: Despite the rarity of tuberculosis evidence in the oral cavity, oral tuberculosis should be included in the differential diagnosis of chronic oral lesions. To prevent ineffective oral therapy, accurate diagnosis is crucial for successful care by concentrating on the pathological source.

Background: Tuberculosis is an infectious disease which is the second-largest cause of death in the world after HIV / AIDS. Tuberculosis caused by Mycobacterium tuberculosis that usually attacks the lungs but can manifest in the oral mucosa. Clinical manifestations of oral Tuberculosis related to age, sex, duration of treatment, systemic disease, and Multi-Drug Resistant therapy. There is no research on descriptive studies of oral manifestations of tuberculosis patients in South Kalimantan, specifically in Banjarmasin. This study aims to analyze the clinical manifestations of oral Tuberculosis descriptively in South Kalimantan, Indonesia. Method: This was a descriptive analysis with cross-sectional study design, based on history and clinical oral examination. It was used 30 respondents by purposive sampling method. Data were analyzed by Chi-square (p0.05). The clinical manifestations of oral Tuberculosis are xerostomia, candidiasis, and angular cheilitis. Conclusion: The duration of treatment and the systemic diseases are associated with xerostomia and candidiasis in the oral cavity of TB patients.

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Tuberculosis (TB) is a serious infectious disease with considerable fatality, typically affecting the pulmonary system and, rarely, other body organs including the oral cavity. Due to the rarity of oral TB, it is frequently overlooked in differential diagnosis of oral lesions. Despite a declining trend in TB incidence in recent years, it is still a major public health problem with high contagiousness, thereby requiring the early diagnosis and prompt treatment. Case presentation A 57-year-old male patient presented with chief complaint of painful ulcer on tip of his tongue. He reported that the ulcer developed without any remarkable event such as mechanical trauma, vesicle formation or systemic illness. His past medical history revealed the TB over 40 years ago, which had reportedly healed after pharmacological treatments. As the ulceration persisted after topical steroid application and careful education about avoiding possible mechanical stimuli, biopsy was performed and histological finding showed typical findings of oral tuberculosis including intense granulomatous inflammatory features with small red rods of mycobacterial organisms as well as epithelioid cells and Langhans giant cells. After suitable antituberculosis treatments, oral tuberculosis ulcer was almost completely healed. We present a case of oral TB affecting tip of the tongue in a patient with a history of pulmonary TB and emphasize the understanding of intraoral manifestations for early diagnosis and prompt treatment of TB. Conclusions The present case represented the importance of understanding oral tuberculosis manifestations for dental clinicians who might be frequently the first health care professionals to encounter various oral lesions.

Tuberculosis (TB) is a chronic infectious disease that can affect various parts of the body including the oral cavity. It primarily affects the lungs. TB bacilli can spread hematogenously to different parts of the body and this also involves maxilla or mandible. Although oral lesions are infrequent, they are crucial for the early diagnosis and interception of primary TB. Intercepting the disease early will limit the morbidity and mortality of the patients. It becomes the responsibility of the dentist to include TB in the differential diagnosis of suspicious oral lesions to prevent delay in the treatment of the disease. It would not be an exaggeration if the dental identification of the TB lesions has the potential of serving as a significant aid in the first line of control for this hazardous and often fatal disease. This article will also emphasize the advancing role of oral pathologists in making the final diagnosis of this dreaded disease.

Tuberculosis is chronic multisystemic disease caused mostly by Mycobacterium tuberculosis. The disease has its mention in the Vedas and Chakra and Sushruta described the features in the early 600 B.C. TB has a known site predilection for lungs, although, extra pulmonary cases have also been reported. The oral tuberculous lesions are a rare occurrence with atypical signs and symptoms, thus deferring an accurate diagnosis and treatment. A plethora of standard and contemporary diagnostic adjuncts facilitate the rapid and precise diagnosis. Anti-tubercular regimen forms the mainstay of treatment, although several recent drugs are also in clinical trial phase. This article aims to highlight the etio-pathogenesis, clinical and oral features of tuberculosis, diagnostic tools, and management protocol for tuberculosis. There is also a brief mention on the various policies considered by World health Organization (WHO) to combat this dreaded disorder. [ABSTRACT FROM AUTHOR]

Tuberculosis involving organs other than the lungs is termed as 'extra pulmonary tuberculosis'. Tuberculosis (TB) remains a worldwide public health problem despite the fact that the causative organism was discovered more than 100 years ago. The present study was conducted to assess different manifestations of tuberculosis affecting the ear, nose and throat (ENT) in patients attending the outpatient department in a total of 520 cases of tuberculosis. One hundred and eight cases were of extra pulmonary tuberculosis. Sixty nine cases had the manifestations of TB in the ENT region. These included patients with tuberculous cervical lymphadenopathy (91.35), laryngeal TB (4.3%), tuberculous otitis media (1.4%), nasal TB (1.4%) and oral tuberculosis (1.4%). Extra pulmonary tuberculosis constitutes about 15-20% of all tuberculosis cases as per WHO survey and it is 20.6% in the present study. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is still one of the most life-threatening infectious diseases, resulting in high mortality in adults and is commonly found in developing countries. Lung is primarily affected while extrapulmonary TB is rarely encountered. Oral lesions, although rare, can be seen in both primary and secondary stages of TB. Primary oral TB may present a diagnostic challenge as its clinical features can be nonspecific that mimics other diseases and is usually misdiagnosed. Thus, it is very important to be aware and be highly suspicious of oral TB especially in endemic area. We share 4 such cases of primary oral TB with uncommon presentations (two on the gingiva, one on the palate and one on the tongue) The diagnosis was made by histopathological examination, polymerase chain reaction analysis and Mantoux test. They were successfully treated with antituberculous treatment. In secondary TB, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes or in any other part of the body and can be detected by a systemic examination. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis is an infectious disease which is the second largest cause of death in the world after HIV / AIDS. Tuberculosis caused by Mycobaterium tuberculosis that usually attacks the lungs but can manifest in the oral mucosa. Clinical manifestations of oral tuberculosis related to age, sex, duration of treatment, systemic disease and Multi Drug Resistant therapy. There is no research on descriptive studies of oral manifestations oftuberculosis patients in South Kalimantan specifically in Banjarmasin. Purpose: To analyze descriptively the clinical manifestations of oraltuberculosis inSouth Kalimantan, Indonesia. Method: This was a descriptive analysis with a cross sectional study design, based on history and clinical oral examination. It was used 30 respondents by purposive sampling method. Data was analyzed by Chi square(p<0.05). Results: During treatment it showed the correlation between xerostomia and systemic disease (p=0.007) and correlation between xerostomia and duration of treatment(p=0.024). The correlation between candidiasis and systemic disease (p=0.024). The correlation between angular cheilitis and age, sex, duration of treatment, systemic disease and Multi Drug Resistant therapy (p>0.05). Conclusion: The clinical manifestations of oral tuberculosis are xerostomia, candidiasis and angular cheilitis. The duration of treatment and the systemic diseases are associated with xerostomia and candidiasis in the oral cavity of TB patients. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is one of the world’s deadliest infectious diseases and predominantly affects the lungs. TB could also occur in other sites of the body, such as the oral cavity. The oral manifestation incidence of TB is approximately 0.05%–5%. Despite being a rare occurrence, oral TB remains a challenging issue because of its nonspecific clinical presentation. This study aims to assess and determine the oral lesions of patients with TB. In this cross-sectional study, we examined the oral cavity of patients with TB to assess the appearance of oral lesions in each patient. In 30 patients with pulmonary TB, we identified 29 oral lesions on the tongue. One patient was suspected with oral tubercular lesion, and four patients had Candida infection–related lesions. Most lesions were classified as normal variant lesions of the oral mucosa, with the coated tongue exhibiting the highest incidence. The tongue is often affected by patients’ systemic condition. Conclusion: Results suggest that although most patients with TB have oral lesions, the oral TB incidence remains rare. Considering that some lesions might be asymptomatic, dentists could play a vital role in the early diagnosis of lesions for further management. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is a chronic infectious disease that can affect various parts of the body including the oral cavity. It primarily affects the lungs. TB bacilli can spread hematogenously to different parts of the body and this also involves maxilla or mandible. Although oral lesions are infrequent, they are crucial for the early diagnosis and interception of primary TB. Intercepting the disease early will limit the morbidity and mortality of the patients. It becomes the responsibility of the dentist to include TB in the differential diagnosis of suspicious oral lesions to prevent delay in the treatment of the disease. It would not be an exaggeration if the dental identification of the TB lesions has the potential of serving as a significant aid in the first line of control for this hazardous and often fatal disease. This article will also emphasize the advancing role of oral pathologists in making the final diagnosis of this dreaded disease. [ABSTRACT FROM AUTHOR]

Oral tuberculosis (TB) is a chronic infectious granulomatous disease that can present with ulceration in the oral cavity. This article presents a case of reactivated TB which presented as a painful oral ulcer in a patient on immunosuppressive medication. It is important for clinicians to be aware of TB when considering a differential diagnosis for oral ulceration, especially in patients who have been prescribed biological agents or other immunosuppressive medications. A delay in the diagnosis can have serious consequences to both the individual and the wider community. [ABSTRACT FROM AUTHOR]

Pulmonary tuberculosis (TB) is the most common form of TB. Primary infection can also affect the pharynx, cervical lymph node, intestine, or oral mucosa. Historically, the observed incidence of concomitant infection with leprosy and TB is high. However, reports of concomitant infection in modern literature remain scarce. Most cases reported in the literature had borderline/lepromatous leprosy and pulmonary tuberculosis. Extrapulmonary tuberculosis is reported in only 3.2% of leprosy cases. To the best of our knowledge, this is the first case report of primary oral tuberculosis of the tongue in a patient with lepromatous leprosy with Type 2 lepra reaction. The patient was referred to Directly Observed Treatment, Short-Course clinic and started on Category I treatment. She received oral prednisolone for lepra reaction, which was subsequently tapered and stopped, however, she continued to receive other antileprotic drugs (thalidomide and clofazimine). The patient's general condition improved and she is on regular follow up.

Orofacial tuberculosis (TB) is an uncommon form of extrapulmonary TB and is nonspecific in its clinical presentation. It can be misdiagnosed especially when oral lesions are present before systemic symptoms become apparent. Doctors especially attending dentist who generally is the first among clinicians to come across such pathological entity should be aware of the orofacial lesions of TB and consider them in the differential diagnosis of suspicious oral lesions to ensure early diagnosis of TB and its treatment. In this review, we have discussed in detail the clinical presentation of various forms of orofacial TB, diagnosis, and management of patients. Also, an update is provided about recent anti-TB drug development.

Copyright of China Journal of Oral & Maxillofacial Surgery is the property of Shanghai Jiao Tong University, College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tuberculosis is a chronic granulomatous lesion, which primarily has an affinity for the lungs. It can involve other sites like lymph nodes, kidney, oral cavity. Infection of the oral cavity by M. tuberculosis can be as a Primary infection or as a Secondary infection. Primary presentation of oral tuberculosis is in the form of the chronic non healing ulcer. A Primary infection or an Asymptomatic Secondary infection can impose a great diagnostic dilemma, as it may mimic neoplasia. Here we present a case of a 32-year-old asymptomatic female with secondary infection. [ABSTRACT FROM AUTHOR]

Background : Oral lesions of tuberculosis (TB) are rare and usually associated with the secondary form of the disease. Aim : The aim of the present study was to determine the prevalence of oral lesions in a cohort of TB-infected individuals. Materials and Methods : The study was carried out in two reference centers for the treatment of TB in Recife, Brazil. All patients treated for TB in the period from July 2008 to March 2009 were included in the study. The data was subjected to descriptive statistical analysis. Results : One hundred and twenty-one patients were included in the study. A marked male prevalence was observed, with a male:female ratio of 6.12:1. HIV coinfection was a common event (33%). Head and neck lesions of TB were rare. Cervical node enlargement was observed in seven individuals (5.8%) and oral ulceration in one patient (0.8%). Discussion : The low prevalence of oral lesions of TB is in accordance with other studies. Nodal involvement is the most common form of head and neck disease. Conclusion : While TB may be a common accompanying feature of HIV disease, orofacial complications of TB are rare in individuals resident in northern Brazil.

Pulmonary tuberculosis (TB) is the most important form of the disease, although infection may also occur by way of the intestinal tract, tonsils and skin. Oral lesions consist of persistent ulcers or granulomatous masses. A 50 year old man had been diagnosed “necrotising granulomatous inflammation” following a biopsy of a lesion on lower lip, 21 months before at a medical centre. A chest-X-ray had not been performed and he had not been given any advise in respect of treatment. He was admitted to the hospital with cough, sputum, weakness, weight loss and lesions on his lower lip. In radiology, it was detected that he had supraclavicular, submental, cervical, mediastinal lymphadenopathies, pulmonary infiltrations with cavities, thickening and roughness on left oropharengial tonsil, thickenning on inner parts of larynx and bilateral surrenal thickening. The biopsy of lesions on larynx, tonsil and epiglottis revealed “necrotising granulomatous inflammation” and histopathology supported TB infection. Sputum acid-fast bacilli was positive and culture was positive for Mycobacterium tuberculosis complex. Two months of combination treatment resulted in a gradual relief of the symptoms, radiological response, disappearing of neck swelling and healing of lesions on lip, tonsil and larynx. Although unusual oral cavity manifestations of TB are rare, clinicians should be aware of possible occurrance.

There is a well-known phrase that states, "The more things change, the more they stay the same." This expression continues to apply to tuberculosis (TB), a widespread infectious disease traced back to the earliest of centuries. TB has claimed its victims throughout much of known human history. Mycobacterium tuberculosis may have killed more persons than any other microbial pathogen and is one of the major causes of ill health and death worldwide. Although the overall incidence of TB has decreased, recently, the incidence of this disease appears to be increasing. Oral lesions of TB though uncommon are seen in both the primary and secondary stages of the disease. In secondary TB, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes, or in any other part of the body and can be detected by a systemic examination. Most of the cases are secondary to pulmonary disease and the primary form is uncommon. Here, we present a case of primary oral TB, affecting the gingiva and hard palate in a 40-year-old Indian female patient.

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pulmonary tuberculosis (TB) is the most common form of TB. Primary infection can also affect the pharynx, cervical lymph node, intestine, or oral mucosa. Historically, the observed incidence of concomitant infection with leprosy and TB is high. However, reports of concomitant infection in modern literature remain scarce. Most cases reported in the literature had borderline/lepromatous leprosy and pulmonary tuberculosis. Extrapulmonary tuberculosis is reported in only 3.2% of leprosy cases. To the best of our knowledge, this is the first case report of primary oral tuberculosis of the tongue in a patient with lepromatous leprosy with Type 2 lepra reaction. The patient was referred to Directly Observed Treatment, Short-Course clinic and started on Category I treatment. She received oral prednisolone for lepra reaction, which was subsequently tapered and stopped, however, she continued to receive other antileprotic drugs (thalidomide and clofazimine). The patient’s general condition improved and she is on regular follow up. [ABSTRACT FROM AUTHOR]

Oral lesions of tuberculosis though uncommon, are seen in both the primary and secondary stages of the disease. In secondary tuberculosis, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes, or in any other part of the body and can be detected by a systemic examination. Primary oral tuberculosis may present as a diagnostic challenge for the clinician. Here we report two patients with primary tuberculosis in the oral cavity who presented to the dental department, were diagnosed and referred for medical management.

Tuberculosis is a chronic granulomatous disease caused by Mycobacterium tuberculosis. There are two forms namely primary and secondary tuberculosis. Pulmonary tuberculosis is the most common form of primary tuberculosis. Primary tuberculosis in extrapulmonary site, though very uncommon, can occur in any site such as skin, brain, bone, eye, genitourinary tract and oral cavity. A 50-year-old male reported with complaint of swelling in the left maxillary region for 3 months duration. Intraorally diffuse firm swelling in the buccal mucosa with mild tenderness, free of secondary changes was present. Histhopathological report revealed Langhans′ giant cell suggestive of tuberculous granuloma. This article emphasis the fact that primary oral tuberculosis should be considered as differential diagnosis of soft tissue swellings, as the communicable nature of the disease demands early diagnosis and treatment.

This paper aims at characterizing clinical features, occurrence, diagnostic process and treatment of oral tuberculosis (TB), basing on the available literature. OralTB manifestations are uncommon and usually secondary to pulmonary changes. They predominantly appear as ulcers. Eruptions are usually single, painful and resistant to conventional treatment. Diagnosis always needs to be confirmed histopathologically. Anti-tubercular systemic therapy is required in every patient diagnosed with oral TB, while topical treatment is only adjuvant. A low incidence of oral TB together with a non-specific clinical picture might pose difficulties in its diagnosis. Oral changes in TB are likely to be overlooked what can result in further spread of Mycobacterium tuberculosis due to a delay in instituting proper treatment. Tuberculosis morbidity has risen recently and more multi-drug resistant strains of TB bacilli are found, what can result in a higher incidence of oral TB. Clinicians should be therefore aware of a possible occurrence of this entity and consider it while making a differential diagnosis of atypical oral changes. [ABSTRACT FROM AUTHOR]

Orofacial tuberculosis (TB) is an uncommon form of extrapulmonary TB and is nonspecific in its clinical presentation. It can be misdiagnosed especially when oral lesions are present before systemic symptoms become apparent. Doctors especially attending dentist who generally is the first among clinicians to come across such pathological entity should be aware of the orofacial lesions of TB and consider them in the differential diagnosis of suspicious oral lesions to ensure early diagnosis of TB and its treatment. In this review, we have discussed in detail the clinical presentation of various forms of orofacial TB, diagnosis, and management of patients. Also, an update is provided about recent anti-TB drug development. [ABSTRACT FROM AUTHOR]

Background: Oral lesions of tuberculosis (TB) are rare and usually associated with the secondary form of the disease. Aim: The aim of the present study was to determine the prevalence of oral lesions in a cohort of TB-infected individuals. Materials and Methods: The study was carried out in two reference centers for the treatment of TB in Recife, Brazil. All patients treated for TB in the period from July 2008 to March 2009 were included in the study. The data was subjected to descriptive statistical analysis. Results: One hundred and twenty-one patients were included in the study. A marked male prevalence was observed, with a male:female ratio of 6.12:1. HIV coinfection was a common event (33%). Head and neck lesions of TB were rare. Cervical node enlargement was observed in seven individuals (5.8%) and oral ulceration in one patient (0.8%). Discussion: The low prevalence of oral lesions of TB is in accordance with other studies. Nodal involvement is the most common form of head and neck disease. Conclusion: While TB may be a common accompanying feature of HIV disease, orofacial complications of TB are rare in individuals resident in northern Brazil. [ABSTRACT FROM AUTHOR]

Kakisi OK, Kechagia AS, Kakisis IK, Rafailidis PI, Falagas ME. Tuberculosis of the oral cavity: a systematic review. Eur J Oral Sci 2010; 118: 103–109. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci The recent increase in the incidence of tuberculosis, combined with an emerging global resistance to antituberculous drugs, warrants an increased awareness of the involvement of Mycobacterium tuberculosis in persistent or atypical lesions in the oral cavity. We sought to review the published reports of mycobacterial infection of the oral cavity found in the literature in otherwise uncompromised patients, from 1950 to the present day, and analyzed the documented manifestations. M. tuberculosis infects all parts of the mouth (soft and hard palate, uvula, buccal mucosa, gingivae, lips, tongue, maxilla, and mandible) more often in men than in women, appearing predominantly in the form of ulcerative lesions. It was found as a secondary infection in 58% (54% pulmonary, 4% extrapulmonary) of patients and as a primary infection in 42% of patients. Carcinomas are found to co-exist in the same lesion site in 3% of patients. In approximately 50% of patients, an oral manifestation of TB has led to the diagnosis of a previously unknown systemic infection, which resulted in a timely and effective treatment. The investigation for tuberculosis should therefore be actively pursued in the dental surgery. Diagnostic work-up for systemic involvement and control of healthcare-associated spread is important, while therapeutic options are still considered adequate. [ABSTRACT FROM AUTHOR]

Background HIV disease has many oral manifestations including tuberculosis, which most commonly presents as irregular ulceration of the tongue or the palate. We detail an HIV-infected patient found to have tuberculosis of the lip. Conclusions To our knowledge tuberculosis of the lips has never been reported in conjunction with HIV infection, and in this case establishing the oral diagnosis resulted in the diagnosis of disseminated disease. [ABSTRACT FROM AUTHOR]