Primary lingual tuberculosis in immunocompetent patient: a case report

A buccal mucosa ulcer as the first sign of tuberculosis

Tuberculosis (TB) is an infectious disease caused mostly by Mycobacterium tuberculosis. Oral lesions caused by this disease are not common, and most of them represent secondary involvement of the initial pulmonary focus. Therefore, the discovery of lung tuberculosis because of the investigation of oral lesions is rare. This paper reports a case of a 61-year-old male patient who presented with a painfully ulcerated lesion in labial commissure and buccal mucosa, without any comorbidities or symptoms associated. An incisional biopsy was performed, and histopathology showed a chronic granulomatous lesion extending to involve the underlying muscle. Based on these findings, investigation for tuberculosis was suggested. Chest radiography displayed excavated macronodular lesions suggestive of an inflammatory-infectious/granulomatous process of bronchogenic dissemination. The search for acid-alcohol-resistant bacillus in sputum was positive. After using drug therapy for tuberculosis for 3 months, there was a total regression of the oral lesions, in addition to weight recovery in the period. Thus, in patients with isolated oral mucosa lesions, we must consider the possibility of oral manifestation of systemic diseases, even without typical clinical signs and symptoms.

Orofacial Bacterial Infectious Diseases: An Update

OBJECTIVES

Most of the oral infections with odontogenic origin are very common and can be treated by tooth extraction, endodontic therapy, or surgical treatment. Other infectious lesions are the manifestations of systemic diseases such as tuberculosis and syphilis. Skin and underlying subcutaneous tissue, fascia, or muscle is also involved with infectious diseases which range from superficial epidermal infections to very serious necrotizing fasciitis.

MATERIALS AND METHODS

An extensive literature in PubMed, Google Scholar, and Scopus search was performed from 1980 to 2017. All related articles were analyzed.

RESULTS

Most oral infections have odontogenic origin. Skin and the underlying subcutaneous tissue, fascia, or muscles are also involved with infectious diseases which range from superficial epidermal infections to very serious necrotizing fasciitis.

CONCLUSIONS

These facts prove that the interaction between the oral cavity, face skin, and the other organs can risk the people's life. The establishment of a correct diagnosis and recognition of clinical findings are the crucial steps to support and improve professional orofacial health status.

Oral Tuberculosis: A Rare Manifestation of Disseminated Disease in a Patient with Dermatomyositis on Chronic Corticosteroids

Tuberculosis remains one of the leading causes of death around the world despite advancements in diagnostic testing and medical therapies. It commonly affects the lungs, but isolated extra pulmonary clinical manifestations have been reported. Tuberculosis of the oral cavity is exceedingly rare. We present a case of a patient with dermatomyositis on chronic steroid therapy, who presented with tuberculosis involving the tongue as the only clinical manifestation of disseminated disease. Physicians must be aware of extra pulmonary manifestations of tuberculosis in patients at risk, in order to avoid delays in diagnosis and treatment and to prevent further contagion.

Oral manifestation of tuberculosis: a case-report

The present case-report describes tuberculosis on the oral mucosa, in a rare manifestation of the disease. The importance of appropriate diagnosis and awareness of the clinical manifestations is highlighted. Oral lesions seem to occur as chronic ulcers, nodular or granular areas, and rare, firm leukoplakia regions. Most extra-pulmonary lesions represent secondary infections of a primary lung infectious focus; therefore, early and accurate diagnosis is required for planning of the best treatment and strategies to control the disease.