Tuberculosis of temporomandibular joint presenting as swelling in the preauricular region

Rare Presentation of Tuberculous Osteomyelitis of Mandibular Condyle Mimicking as Parotid Tumor: A Case Report

Tuberculosis (TB) is a significant health problem and mortality in most developing countries. It is a chronic granulomatous disease caused by Mycobacterium tuberculosis and M. tuberculosis complex. It can be pulmonary form or Extra pulmonary form. Extrapulmonary tuberculosis involving temporomandibular joint is infrequent presentation of Skeletal TB. Here we present a rare case of extrapulmonary tuberculosis that was initially misdiagnosed as a parotid lesion due to atypical signs and symptoms and multiple in-conclusive FNAC reports. The final diagnosis was established by histopathological report.

A case report of temporomandibular joint tuberculosis in a neonate with eleven years follow-up

Background

Tuberculosis of the Temporomandibular joint (TMJ) in a neonate is a rare entity. Undiagnosed/mismanaged tuberculosis can disseminate and be life-threatening to the patient. The purpose is to present a case of tubercular osteomyelitis of TMJ in a neonate with eleven years of follow-up.

Case presentation

A one-and-a-half-month-old male neonate presented with a firm swelling in front of the left ear for the past 20 days. Ultrasound presented an avascular, hypoechoic lesion of 34*25*25mm. Irregular margins of underlying bone could suggest erosion. Aspiration revealed pus. ZN staining of pus revealed Mycobacterium tuberculosis. After draining the pus, the patient underwent antitubercular therapy. He revisited at ten years of age with a complaint of asymmetry. Although the patient got cured of his tuberculosis, investigations rose to a diagnosis of condylar hypoplasia with ipsilateral coronoid enlargement. A distraction of the mandible improved facial symmetry.

Conclusion

Although pus revealed the presence of Acid-fast bacilli, it is not evident until there is a significant bacterial load. Escalation of tests with higher sensitivity is needed to diagnose tubercular osteomyelitis of TMJ. Patients must be made aware of possible sequelae of tubercular osteomyelitis of TMJ and need appropriate management. Oblique osteotomy at the angle and distraction improves both horizontal and vertical components of the mandible and thus improves symmetry. To the best of the author's knowledge, the following is the first case of primary tuberculosis of TMJ in a neonate and with such an extended follow-up.

Can Oral TB develop in susceptible individuals after an oral surgical procedure? 3 case reports

As opposed to the popular assumption, there have been an increase in the cases of Oral Tuberculosis as of late. Owing to increased drug resistance, there has been a change in the disease pattern leading to an upsurge in the Extra-pulmonary Oral Tuberculosis. According to the WHO, Diagnosis is the first step in the control of TB; but due to the lack of pathognomonic signs associated with Oral Tuberculosis and the rarity of these lesions, diagnosis is often difficult. So, to enable a timely diagnosis, we point out the occurrence of such lesions in the post-operative refractory lesions in susceptible individuals. However, a thorough search of literature did not yield any conclusive results. In this paper we present the clinical, radiographic and histopathological findings of three cases between the ages of 5 and 50 years old who were diagnosed of Oral Tuberculosis. These patients have undergone a recent oral surgical procedure prior to the development of Oral TB lesions. More research is required to increase the awareness of the pattern of this disease and to enable a quicker diagnosis so that the overall morbidity and mortality is reduced.

Mycobacterial and Plasmodium ovale-associated destruction of the jaw bones

OBJECTIVES

The project aims were to identify infectious mechanisms responsible for an extreme form of mandibular osteonecrosis and osteomyelitis in West African populations and test the hypothesis that Mycobacterium tuberculosis plays a pivotal role.

MATERIALS AND METHODS

DNA was extracted from mandibular fragments of 9 of 19 patients previously included in a prospective study leading to the mycobacterial hypothesis. Amplified DNAs were used for preparing libraries suitable for next-generation sequencing. For comparison of the whole-genome sequencing data of the 9 patients with DNAs of both microbiota and human tissues, DIAMOND v0.9.26 was used to align sequencing reads to NCBI-nr database and MEGAN 6 for taxonomy binning and identification of Mycobacterium tuberculosis strains.

RESULTS

The data show that mandibular bone fragments of all 9 patients not only contain Homo sapiens and Mycobacterium tuberculosis DNAs; they also contain DNAs of Plasmodium ovale wallikeri, Staphylococcus aureus, Staphylococcus hominis, and Prevotella P3-120/intermedia; as well as large numbers of DNAs from other infectious components.

CONCLUSIONS

The data obtained provide direct evidence to support the conclusion that combinations of Mycobacterium tuberculosis, Plasmodium ovale wallikeri, and other oral bacteria are involved in this particular type of mandibular destruction in West African individuals of many ages.

Infectious arthritis and the temporomandibular joint. A review

OBJECTIVE

Microorganisms can cause acute infectious arthritis, chronic infectious arthritis, or reactive inflammatory arthritis. The aim of this study is to perform a narrative review of the pathophysiology, etiology, and diagnostic features of infectious arthritis and TMJ infectious arthritis.

METHODS

A search of the literature was performed using Medline, Scielo, Embase, and Google Scholar databases. The terms employed for the search were "Temporomandibular Joint Disorders" and "Infectious Arthritis"; or "Septic Arthritis"; or "Bacterial, Fungal, or Viral Arthritis." Over three hundred articles were screened for eligibility.

RESULTS

The selected articles were utilized to perform a narrative review of the general aspects of infectious arthritis and infectious arthritis affecting the TMJ.

CONCLUSION

Infectious arthritis is a rare, yet very morbid, form of arthritis. Understanding general aspects of joint infections and specific features of TMJ infectious arthritis is imperative for an adequate diagnosis.

Orofacial tuberculosis: Clinical manifestations, diagnosis and management

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.

Overlap between functional GI disorders and other functional syndromes: what are the underlying mechanisms?

BACKGROUND

Irritable bowel syndrome and other gastrointestinal (GI) and non-GI disorders such as functional dyspepsia, fibromyalgia, temporomandibular joint disorder, interstitial cystitis/painful bladder syndrome, and chronic fatigue syndrome are known as functional pain syndromes. They commonly coexist within the same individual. The pathophysiologic mechanisms of these disorders are not well understood, but it has been hypothesized that they share a common pathogenesis.

PURPOSE

The objective of this review is to discuss the proposed pathophysiologic mechanisms, which have been similarly studied in these conditions. These mechanisms include enhanced pain perception, altered regional brain activation, infectious etiologies, dysregulations in immune and neuroendocrine function, and genetic susceptibility. Studies suggest that these functional disorders are multifactorial, but factors which increase the vulnerability of developing these conditions are shared.