Oral tuberculosis. Two case reports.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report a case of oral tuberculosis in an elderly non-immunodepressed patient. We emphasize and discuss the main epidemiological and clinical aspects as compared with the more common pictures of the past.
Human immunodeficiency virus/tuberculosis (HIV/TB) co-infected subjects demonstrate enhanced HIV replication and plasma viremia; CD4+ T-cell depletion; morbidity and mortality; and susceptibility to secondary bacterial and fungal infections compared to subjects solely infected with HIV. As the incidence of HIV/TB infection has been increasing, one would have expected to encounter oral lesions of tuberculosis more frequently. However, such oral lesions are uncommon. The lesions usually occur as ulcerations of the tongue. We report an additional case in an HIV/TB co-infected 39 year-old black male, who presented with chronic, painless, multiple oral ulcers, occurring simultaneously on the tongue, bilaterally on the palate and mucosa of the alveolar ridge. Microscopic examination confirmed the presence of chronic necrotizing granulomatous inflammation, with the identification of acid fast bacilli in the affected oral mucosal tissue. Anti-retroviral and anti-tuberculous treatment resulted in the resolution of the oral lesions. Confirmatory histopathological diagnosis following a biopsy is essential to determine the exact nature of chronic oral ulceration in an HIV individual and especially to distinguish between oral squamous cell carcimoma, lymphoma, infection (bacterial or fungal) and non-specific or aphthous type ulceration.
We present a case of primary oral tuberculosis, affecting the maxillary gingiva and causing alveolar bone loss in a 34-year-old Colombian female patient. Definitive diagnosis was facilitated by polymerase chain reaction analysis, a useful modern tool for the diagnosis of infectious diseases. The location and clinical presentation of this lesion is unusual and underlines the importance of considering tuberculosis in the differential diagnosis of oral lesions that affect the gingiva and alveolar bone.
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The polymerase chain reaction (PCR) assay is a powerful tool for quick diagnosis of various infectious diseases. We applied this technique as well as conventional histopathological examination to diagnose oral tuberculosis. Ziehl-Neelsen staining of oral mucosal specimens often fails to detect Mycobacterium (M.) tuberculosis due to the low number of bacteria in the tissue. Specific primers and probes were synthesized based upon the nucleotide sequence of the 65 kDa membrane protein of M. tuberculosis. DNA extracted from the paraffin-embedded tissue was amplified using taq polymerase. PCR assay detected M. tuberculosis in 5 of 6 samples. Although the gene segments from these species were quite similar, the gamma 32P labeled noligonucleotide probes distinguished between M. tuberculosis and M. fotuitum by southern blot hybridization. In all specimens that were Ziehl-Neelsen negative, M. tuberculosis DNA was detected by PCR. These results suggest that PCR is a useful means of diagnosing mycobacterium infection.
Tuberculous lesions of the oral cavity are rare, primary lesions in particular. Three cases of different location are reported, two of them are secondary to pulmonary disease and the third one is a primary lesion after tooth extraction. Based on these cases and the literature reviewed we analyze the differences of these clinical situations, the diagnostic procedures needed and the excellent response they shows to treatment with tuberculostatic drugs.
Tuberculosis can affect any part of the body and oral cavity remains no exception. The oral lesions of tuberculosis, though not common, are seen in various forms. The purpose of this article is to emphasize the importance of early diagnosis of primary tuberculosis of the mouth, which may be misdiagnosed when the oral lesions are the sole manifestation of the disease.
Although rare, doctors and dentists should be aware of the possible occurrence of oral lesions of tuberculosis and consider them in the differential diagnosis of suspicious oral ulcers.
Two cases are hereby presented, diagnosed through clinical, laboratory radiology and histological methods. In each case, the oral involvement was associated with pulmonary tuberculosis. The trauma, particularey in the teeth, is an important deciding factor. Clinically, some ulcerous lesions in mucous membranes and tongue were observed, with definite characteristics such as quite severe pain, difficulty in swallowing and talking. The selected treatment has been chemical therapy. Looking back at hospital files, these two cases have been the only ones observed at Hospital de San Jaun de Dios of Bogotá, in the last fifteen years.