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Khan MA, Rahman SA, Danish M, Afrose R. A Rare Case of Tubercular Osteomyelitis of Mandible in a 5-year-old Child. Int J Clin Pediatr Dent 2024; 17:202-205. [PMID: 39184890 PMCID: PMC11339488 DOI: 10.5005/jp-journals-10005-2763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
Tuberculosis (TB), also known as Koch's disease, is a chronic granulomatous disease typically caused by Mycobacterium tuberculosis (M. tuberculosis). On 24th March 1882, Dr Robert Koch discovered M. tuberculosis that caused TB. In humans, M. bovis and atypical mycobacterium may also cause this disease. According to the World Health Organization (WHO) Global Report 2022, published on 27th October 2022, the incidence of TB in India for the year 2022 is 210/100,000 population. Primarily, TB affects the pulmonary region in humans, whereas secondarily, it may affect extrapulmonary sites such as the bones and intestines via lymph nodes. In this article, we are reporting a rare case of tubercular osteomyelitis of the mandible, in which the patient reported swelling of the cheek, mimicking an odontogenic infection that led to mandibular osteomyelitis. The definitive diagnosis of tubercular osteomyelitis was made by cartridge-based nucleic acid amplification test (CB-NAAT) when the cheesy material was found during surgical debridement and curettage of the mandible. Following that diagnosis, antitubercular treatment (ATT) was started immediately for the patient, which led to the complete resolution of the disease. The patient has been on regular follow-up for the last six months with no evidence of relapse of disease. Primary TB of the mandible is very rare, with only a few reported cases in the literature. How to cite this article Khan MA, Rahman SA, Danish M, et al. A Rare Case of Tubercular Osteomyelitis of Mandible in a 5-year-old Child. Int J Clin Pediatr Dent 2024;17(2):202-205.
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Affiliation(s)
- Mohd Aswad Khan
- Department of Oral and Maxillofacial Surgery, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sajjad Abdur Rahman
- Department of Oral and Maxillofacial Surgery, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Mohammad Danish
- Department of Oral and Maxillofacial Surgery, Dr Ziauddin Ahmad Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Ruquiya Afrose
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Tang J, Zuo J, Fu H. A case of oral tuberculous ulcer and literature review. Clin Case Rep 2023; 11:e8216. [PMID: 38076017 PMCID: PMC10697859 DOI: 10.1002/ccr3.8216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 10/16/2024] Open
Abstract
Our purpose is to clearly diagnose the tongue and back tuberculosis ulcer through detailed medical history collection combined with examination, so as to provide certain experience for the diagnosis and treatment of oral tuberculosis.
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Affiliation(s)
- Juan Tang
- Department of Oral and Maxillofacial SurgeryBinzhou Medical University HospitalBinzhouChina
- School of StomatologyBinzhou Medical UniversityYantaiChina
| | - Jinhua Zuo
- Department of Oral and Maxillofacial SurgeryBinzhou Medical University HospitalBinzhouChina
| | - Honghai Fu
- Department of Oral and Maxillofacial SurgeryBinzhou Medical University HospitalBinzhouChina
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Sriram S, Hasan S, Saeed S, Ahmad SA, Panda S. Primary Tuberculosis of Buccal and Labial Mucosa: Literature Review and a Rare Case Report of a Public Health Menace. Case Rep Dent 2023; 2023:6543595. [PMID: 37842328 PMCID: PMC10569891 DOI: 10.1155/2023/6543595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/09/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023] Open
Abstract
Tuberculosis (TB) is a chronic granulomatous infectious disorder, caused by Mycobacterium tuberculosis. Despite the recent advancements in antitubercular therapy (ATT), it remains a global public health concern. TB is a leading infectious cause of global mortality, second only to coronavirus disease 2019 (COVID-19). TB of the oral cavity is an uncommon occurrence and may be classified as a primary and secondary form. The primary tubercular lesions are extremely rare, as the intact oral squamous epithelium resists the entry of tubercle bacilli. The commonest oral TB lesion is solitary ulceration with undermined edges, usually on the tongue, that does not exhibit healing with conservative therapies. Owing to the atypical presentation, the oral TB lesions often go unnoticed during clinical examination; hence, an oral physician should be familiar with the various oral manifestations of TB. A timely diagnosis coupled with interdisciplinary treatment is the key to combat disease dissemination. This manuscript aims to report a rare case of primary tuberculosis of the buccal and labial mucosa in a 43-year-old immunocompetent male patient. Buccal and labial mucosa are the infrequently affected sites for primary oral TB lesions. A detailed literature search carried out on the Google Scholar and PubMed search engines revealed only fifteen case reports and two case series of primary tuberculosis of the buccal mucosa and labial mucosa.
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Affiliation(s)
- Shyamkumar Sriram
- Department of Social and Public Health, Ohio University, Athens, Ohio 45701, USA
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shazina Saeed
- Amity Institute of Public Health & Hospital Administration, Amity University, UP, Noida, India
| | - Syed Ansar Ahmad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Swagatika Panda
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Siksha ‘O' Anusandhan University, Bhubaneswar, Odisha, India
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de Farias Gabriel A, Kirschnick LB, Só BB, Schuch LF, Silveira FM, Martins MAT, Wagner VP, Lopes MA, Martins MD. Oral and maxillofacial tuberculosis: A systematic review. Oral Dis 2023; 29:2483-2492. [PMID: 35785411 DOI: 10.1111/odi.14290] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/18/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Amanda de Farias Gabriel
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura Borges Kirschnick
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Felipe Martins Silveira
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Molecular Pathology Area, School of Dentistry, Universidad de la República (UDELAR), Montevideo, Uruguay
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
| | - Vivian Petersen Wagner
- Department of Clinical Dentistry, Academic Unit of Oral and Maxillofacial Medicine and Pathology, University of Sheffield, Sheffield, UK
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Department of Oral Medicine, Hospital de Clínicas de Porto Alegre (HCPA/UFRGS), Porto Alegre, Brazil
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Sharma H, Dahiphale D, Nagarpurkar A, Pole S, Mishrikotkar P. Tuberculosis of the tongue: A rare case. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_197_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Extrapulmonary Tuberculosis—An Update on the Diagnosis, Treatment and Drug Resistance. JOURNAL OF RESPIRATION 2021. [DOI: 10.3390/jor1020015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Pathogenic Mycobacterium tuberculosis complex organisms (MTBC) primarily cause pulmonary tuberculosis (PTB); however, MTBC are also capable of causing disease in extrapulmonary (EP) organs, which pose a significant threat to human health worldwide. Extrapulmonary tuberculosis (EPTB) accounts for about 20–30% of all active TB cases and affects mainly children and adults with compromised immune systems. EPTB can occur through hematogenous, lymphatic, or localized bacillary dissemination from a primary source, such as PTB, and affects the brain, eye, mouth, tongue, lymph nodes of neck, spine, bones, muscles, skin, pleura, pericardium, gastrointestinal, peritoneum, and the genitourinary system as primary and/or disseminated disease. EPTB diagnosis involves clinical, radiological, microbiological, histopathological, biochemical/immunological, and molecular methods. However, only culture and molecular techniques are considered confirmatory to differentiate MTBC from any non-tuberculous mycobacteria (NTM) species. While EPTB due to MTBC responds to first-line anti-TB drugs (ATD), drug susceptibility profiling is an essential criterion for addressing drug-resistant EPTB cases (DR-EPTB). Besides antibiotics, adjuvant therapy with corticosteroids has also been used to treat specific EPTB cases. Occasionally, surgical intervention is recommended, mainly when organ damage is debilitating to the patient. Recent epidemiological studies show a striking increase in DR-EPTB cases ranging from 10–15% across various reports. As a neglected disease, significant developments in rapid and accurate diagnosis and better therapeutic interventions are urgently needed to control the emerging EPTB situation globally. In this review, we discuss the recent advances in the clinical diagnosis, treatment, and drug resistance of EPTB.
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Behera B, Nayak AK, Dash S, Palit A, Purkait S, Mohanty M. Focal ulcero-proliferative gingivitis: A rare presentation of mucosal tuberculosis. Indian J Dermatol Venereol Leprol 2021; 87:106-108. [PMID: 33580931 DOI: 10.25259/ijdvl_486_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Biswanath Behera
- Department of Dermatology, and Venereology, AIIMS, Bhubaneswar, Odisha, India
| | - Ashish Kumar Nayak
- Department of Dermatology, and Venereology, AIIMS, Bhubaneswar, Odisha, India
| | - Siddharth Dash
- Department of Dermatology, and Venereology, AIIMS, Bhubaneswar, Odisha, India
| | - Aparna Palit
- Department of Dermatology, and Venereology, AIIMS, Bhubaneswar, Odisha, India
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Kumari M, Kumar T, Rai S, Rai A, Sultana R, Priya L. Evaluation of Dental Health in Terminally Ill Patients. J Med Life 2020; 13:321-328. [PMID: 33072203 PMCID: PMC7550152 DOI: 10.25122/jml-2020-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Dental health plays an imperative role in the general health and well-being of an individual. Terminally ill patients due to a compromised immune response are susceptible to a wide array of oral complications, which may affect their ability to speak and chew, leading to malnutrition. The present study was conducted to evaluate dental health and various oral manifestations in terminally ill patients. One hundred twenty terminally ill patients hospitalized with diseases of the respiratory tract, gastrointestinal tract, circulatory system, liver, and endocrinal disorders were included in the study. The evaluation of oral manifestations and their prevalence was done by a single examiner. The oral health was evaluated according to symptoms exhibited by the patients and clinical presentation. Of the patients included in the study, 78 were male, and 42 were female. All the individuals were adults between 25 to 55 years of age. Out of 120 admitted terminally ill patients, 27 subjects had respiratory diseases, 17 had gastrointestinal disorders, 5 had disorders of the circulatory system, 39 had liver disorders, and 32 had endocrine disorders. A need for added comprehension is mandatory to link the inter-relationships between dentistry and medicine to further perk up the management of the overall health of patients, which will further reinforce the partnership between dental and medical communities.
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Affiliation(s)
- Minti Kumari
- Department of Public Health Dentistry, Patna Dental College and Hospital, Patna, India
| | - Tanoj Kumar
- Department of Oral Pathology and Microbiology, Patna Dental College and Hospital, Patna, India
| | - Shweta Rai
- Department of Oral and Maxillofacial Surgery, Buddha Institute of Dental Sciences and Hospital, Kankarbagh, Patna, India
| | - Anurag Rai
- Department of Orthodontics, Patna Dental College and Hospital, Bankipore, Patna, India
| | | | - Leena Priya
- Department of Oral Medicine And Radiology, Buddha Institute of Dental Science and Hospital, Patna, India
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Fragoso J, Oliveira MM, Gonçalves C, Méndez J, Sarmento-Castro R. Oral ulcer as presentation of cavitating pulmonary tuberculosis. IDCases 2020; 22:e00976. [PMID: 33083228 PMCID: PMC7554358 DOI: 10.1016/j.idcr.2020.e00976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/26/2020] [Accepted: 09/26/2020] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis is an indolent infection that can invade any organ. Although the most frequent form of presentation is pulmonary, it can have an extra-pulmonary presentation, including rare cases of oral tuberculosis. We present a clinical case of a 44 year-old man, active smoker, with an ulcerated lesion on the posterior third of the tongue, initially interpreted as a probable neoplasm. The pathological study of the biopsy performed on the lesion, showed alterations compatible with a chronic granulomatous process and the presence of acid-fast bacilli. The concomitant diagnosis of pulmonary tuberculosis was made in a subsequent study. The patient started therapy with isoniazid, rifampin, pyrazinamide and ethambutol with complete resolution of the oral lesion and pulmonary tuberculosis. This case exemplifies the importance of including tuberculosis in the differential diagnosis of ulcerated and neoformative lesions and the value of performing a microbiological study alongside the pathological one.
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Affiliation(s)
- Joana Fragoso
- Serviço de Doenças Infeciosas do Centro Hospitalar Universitário do Porto, Portugal
| | | | - Celina Gonçalves
- Serviço de Doenças Infeciosas do Centro Hospitalar Universitário do Porto, Portugal.,Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto, Portugal
| | - Josefina Méndez
- Serviço de Doenças Infeciosas do Centro Hospitalar Universitário do Porto, Portugal
| | - Rui Sarmento-Castro
- Serviço de Doenças Infeciosas do Centro Hospitalar Universitário do Porto, Portugal
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Hirschfeld J, Higham J, Blair F, Richards A, Chapple ILC. Systemic disease or periodontal disease? Distinguishing causes of gingival inflammation: a guide for dental practitioners. Part 2: cancer related, infective, and other causes of gingival pathology. Br Dent J 2020; 227:1029-1034. [PMID: 31873257 DOI: 10.1038/s41415-019-1053-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Periodontitis and gingivitis are highly prevalent inflammatory diseases of the oral cavity, and typically are characterised by the presence of dental plaque. However, other causes of oral inflammation exist, which can resemble plaque-induced gingivitis and periodontitis, and may thus first be seen by a dental practitioner. This paper aims to provide dentists with an understanding of the manifestations of systemic diseases to the periodontium and highlights anamnestic and clinical clues important for distinguishing between plaque-induced and non plaque-induced lesions. In the first part of this series immune-mediated and hereditary conditions as causes of gingival lesions were discussed; this second part highlights cancer-related gingival lesions as well as those caused by specific pathogens, medication or malnutrition. A clear clinical, epidemiological and visual overview of the different conditions is provided. Early diagnosis of non plaque-related causes of gingival lesions can be vital for affected patients. Therefore, dental practitioners should be aware of the various manifestations of systemic diseases to the periodontium.
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Affiliation(s)
- Josefine Hirschfeld
- Department of Periodontology, Birmingham Dental School and Hospital, 5 Mill Pool Way, B5 7EG, Birmingham, UK.
| | - Jon Higham
- Department of Oral Medicine, Birmingham Dental School and Hospital, 5 Mill Pool Way, B5 7EG, Birmingham, UK
| | - Fiona Blair
- Department of Periodontology, Birmingham Dental School and Hospital, 5 Mill Pool Way, B5 7EG, Birmingham, UK
| | - Andrea Richards
- Department of Oral Medicine, Birmingham Dental School and Hospital, 5 Mill Pool Way, B5 7EG, Birmingham, UK
| | - Iain L C Chapple
- Department of Periodontology, Birmingham Dental School and Hospital, 5 Mill Pool Way, B5 7EG, Birmingham, UK
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11
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Rout P, Modipalle V, Hedge SS, Patel N, Uppala S, Shetty PK. Prevalence of oral lesions in tuberculosis: A cross sectional study. J Family Med Prim Care 2019; 8:3821-3825. [PMID: 31879619 PMCID: PMC6924226 DOI: 10.4103/jfmpc.jfmpc_714_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/17/2019] [Accepted: 10/09/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Tuberculosis (Tb) is a fatal infectious disease that primarily affects the pulmonary system and rarely occurs in other body organs including oral cavity. The aim of this study was to report all patients with primary manifestations of oral tuberculosis and to evaluate the clinical characteristics of oral tuberculosis lesions. All these patients were subsequently diagnosed with tuberculosis based on oral histological findings and referred for management and therapy. MATERIALS AND METHODS Twelve patients with oral lesions from the year 2010 to 2018 were histologically diagnosed as having tuberculosis, who did not give any history of the disease, following surgical biopsy. Clinical symptoms, auxiliary examinations, treatments, and outcomes were recorded and analyzed. RESULTS Oral TB was found in all 12 patients; 8 males and 4 females, with male to female ratio 8:4. Involved oral sites included the angle of the mandible (one case), right mandibular molar region (two cases), left mandibular molar region (four cases), gingiva (three cases), buccal mucosa (one case), and the tongue (one case). Oral TB patients in this series ranged in the age group of 6-65 years. All the lesions were suggestive of primary tuberculosis. The appearance of the affected mucosa in oral TB was variable. The most common manifestation was ulceration and swelling of the mucosa. CONCLUSION TB should be considered in patients with oral ulcerations and swellings. A biopsy specimen for histological study, acid-fast stains, and cultures should be obtained for confirmation and differential diagnosis along with other conditions.
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Affiliation(s)
- Purnendu Rout
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Orissa, India
| | - Varsha Modipalle
- Department of Pedodontics and Preventive Dentistry, C.K.S Teja Institute of Dental Sciences and Research, Renigunta, Tirupati, Andhra Pradesh, India
| | - Shruthi S Hedge
- Department of Oral Medicine and Radiology, Srinivas Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Nirav Patel
- Department of Oral and Maxillofacial Surgery, Goenka Research Institute of Dental Sciences, Gandhinagar, Gujarat, India
| | - Sravani Uppala
- Department of Conservative Dentistry and Endodontics, Drs. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Chinaoutpalli, Andhra Pradesh, India
| | - Prajwal K Shetty
- Department of Orthodontics, A.B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
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Sharma S, Bajpai J, Pathak PK, Pradhan A, Singh P, Kant S. Oral tuberculosis - Current concepts. J Family Med Prim Care 2019; 8:1308-1312. [PMID: 31143712 PMCID: PMC6510082 DOI: 10.4103/jfmpc.jfmpc_97_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Supriya Sharma
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
| | - Jyoti Bajpai
- Department of Respiratory Medicine, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
| | - Pankaj K Pathak
- Department of Family and Community Medicine, AIIMS, Patna, Bihar, India
| | - Akshyaya Pradhan
- Department of Cardiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Priyanka Singh
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
| | - Surya Kant
- Department of Respiratory Medicine, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
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Varghese B, Enani M, Alrajhi A, Al Johani S, Albarak A, Althawadi S, Elkhizzi N, AlGhafli H, Shoukri M, Al-Hajoj S. Impact of Mycobacterium tuberculosis complex lineages as a determinant of disease phenotypes from an immigrant rich moderate tuberculosis burden country. Respir Res 2018; 19:259. [PMID: 30587190 PMCID: PMC6307224 DOI: 10.1186/s12931-018-0966-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 12/16/2018] [Indexed: 02/04/2023] Open
Abstract
Background Growing evidences suggested that the Mycobacterium tuberculosis complex (MTBC) lineages can determine the clinical outcome of pulmonary and extra-pulmonary tuberculosis. However, limited data only available revealing such association of bacterial genotypes and clinical phenotypes from immigrant rich countries. Methods A multicenter study has been carried out on a collection of 2092 (1003 extrapulmonary and 1089 pulmonary) MTBC isolates. Genotyping of all the isolates were carried out by spoligotyping and 24 loci based MIRU-VNTR typing. Results Demographically domination of young Saudi nationals (61.4%) and men (61.2%) were found in this cohort. Lymph nodes (62.4%) and gastrointestinal sites (16.7%) were the most common anatomical sites of infection. The predominant lineages were Delhi/CAS (26.9%), EAI (14.2%) and Ghana (9.9%). Mycobacterium africanum type I and II were reported for the first time in the country among extrapulmonary cases. ‘Ancestral’ lineages M.bovis (OR-5.22; 95% CI-2.23-8.22, p- < 0.001) and Delhi/CAS (OR-0.57; 95% CI-0.411-0.734, p- < 0.001) were directly associated with lymph node tuberculosis and gastrointestinal tuberculosis (M. bovis-OR-0.33; 95% CI-0.085-0.567, p-0.001 and Delhi/CAS-OR-1.87; 95% CI-1.22-2.53, p- < 0.001) respectively. Among the ‘Modern’ lineages, EAI showed significant association to central nervous system tuberculosis (OR-1.98; 95% CI-0.76-3.19, p-0.04) and Uganda-I to gastrointestinal tuberculosis (OR-2.41; 95% CI-0.77-4.06, p-0.02). Conclusions The findings substantially contribute to the emerging evidences that MTBC lineages influence disease phenotypes and epidemiological consequences. Electronic supplementary material The online version of this article (10.1186/s12931-018-0966-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bright Varghese
- Department of Infection and Immunity, MBC-03, King Faisal Specialist Hospital and Research Centre, Post Box # 3354, Riyadh, 11211, Saudi Arabia
| | - Mushira Enani
- Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Alrajhi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sameera Al Johani
- Department of Microbiology, King Abdul Aziz Medical City, Riyadh, Saudi Arabia
| | - Ali Albarak
- Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sahar Althawadi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Noura Elkhizzi
- Department of Microbiology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hawra AlGhafli
- Department of Infection and Immunity, MBC-03, King Faisal Specialist Hospital and Research Centre, Post Box # 3354, Riyadh, 11211, Saudi Arabia
| | - Mohammed Shoukri
- National Biotechnology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sahal Al-Hajoj
- Department of Infection and Immunity, MBC-03, King Faisal Specialist Hospital and Research Centre, Post Box # 3354, Riyadh, 11211, Saudi Arabia.
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Vučičević Boras V, Gabrić D, Smiljanić Tomičević L, Seiwerth S, Gršić K, Šarčević B, Lončar Brzak B, Marunica E, Glavina A. Tuberculosis of the Oral Cavity Misdiagnosed as Precancerous Lesion. Acta Stomatol Croat 2018; 51:326-331. [PMID: 29872238 PMCID: PMC5975450 DOI: 10.15644/asc51/4/7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction The aim of this case report was to discuss an extremely rare oral lesion as a result of primary pulmonary tuberculosis. Case report In this case report, the patient with refractory painless ulceration at ventral surface of the tongue was described. Detailed medical history was taken followed by clinical examination of the oral mucosa and palpation of regional lymph nodes. Clinical examination revealed ulceration on the patient’s ventro-lateral surface of the tongue, approximately two centimeters in diameter. Palpation of regional lymph nodes has not revealed enlargement. The toluidine blue test of the suspected lesion was performed at each control examination. Biopsy samples for histopathologic diagnosis were taken three times. The analysis of the first biopsy sample for histopathology revealed a non-specific inflammation, the second biopsy revealed a caseous necrosis without positive Ziehl-Neelsen staining and the third biopsy revealed a granulomatous inflammation which was highly suspicious of sarcoidosis. During hospitalization, the patient underwent a complete physical examination, and laboratory and radiological diagnostics. Physical chest examination revealed bilaterally coarse crepitations and laboratory findings of his complete blood count revealed normocytic anemia of chronic disease. Radiographic examination of lungs showed multiple small nodules bilaterally and positive direct sputum smear. Conclusion Although oral tuberculosis is a rare condition, it must be taken into account in differential diagnosis of refractory painless oral ulcers.
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Affiliation(s)
- Vanja Vučičević Boras
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ljiljana Smiljanić Tomičević
- Department of Clinical Immunology and Rheumatology, Clinic for Internal Medicine, School of Medicine, University of Zagreb, Clinical Hospital Centre Zagreb, Zagreb, Croatia
| | - Sven Seiwerth
- Department of Pathology, School of Medicine, University of Zagreb, Clinical Hospital Centre Zagreb, Zagreb, Croatia
| | - Krešimir Gršić
- Department of Head and Neck Surgery, Clinic for Tumors, Clinical Hospital Centre "Sestre milosrdnice", Zagreb, Croatia
| | - Božena Šarčević
- Department of Pathology, Clinic for Tumors, Clinical Hospital Centre "Sestre milosrednice", Zagreb, Croatia
| | - Božana Lončar Brzak
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Emilija Marunica
- Clinic for Lung Diseases Jordanovac, Clinical Hospital Centre Zagreb, Zagreb, Croatia
| | - Ana Glavina
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Bansal R, Jain A, Mittal S. Orofacial tuberculosis: Clinical manifestations, diagnosis and management. J Family Med Prim Care 2015; 4:335-41. [PMID: 26288770 PMCID: PMC4535091 DOI: 10.4103/2249-4863.161312] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Ramta Bansal
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Sehora, Jammu, Jammu and Kashmir, India
| | - Aditya Jain
- Department of Physiology, Government Medical College, Patiala, Punjab, India
| | - Sunandan Mittal
- Dashmesh Institute of Research and Health sciences, Faridkot, Punjab, India
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