Exploring the Oral Manifestations of Tuberculosis: A Comprehensive Analysis of Prevalence and Clinicopathological Characteristics of Oral Lesions.

BACKGROUND: The study aimed to report all cases of oral tuberculosis (TB), a rare manifestation of the fatal infectious disease primarily affecting the pulmonary system. The report also evaluated the clinicopathological characteristics of oral TB lesions. METHODS: A total of 25 patients who presented with oral lesions between August 2013 and August 2023 were diagnosed with TB through surgical biopsy despite having no prior history of the disease. Their clinical symptoms, auxiliary examinations, treatments, and outcomes were recorded and analyzed for further study. RESULTS: In a study of 25 patients with oral TB, all patients were found to have the disease, with 16 males and 9 females affected. The gender distribution was skewed toward males, with a 1.77 male-to-female ratio. Twelve cases of the affected sites were reported in the mandible, six cases in the buccal mucosa, four in the lips, two in the gingiva, and one in the tongue. The age range of affected patients was 0-70 years old, and all lesions were indicative of primary TB. The appearance of the affected mucosa varied, with ulceration and swelling being the most common manifestations. CONCLUSION: Patients who present with oral ulcerations and swellings should be evaluated for the possibility of TB. To confirm and differentiate this condition from other diseases, obtaining a biopsy specimen for histological analysis and performing acid-fast stains and cultures is recommended. These tests will enable a precise diagnosis and guide appropriate treatment.

ENT manifestations of tuberculosis: an important aspect of ENT practice.

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.

Literature review of oral tuberculosis and report of a case with unique histological presentation.

As a consequence of the emergence of drug resistant tuberculosis (TB) and various immuno-compromised states, there is a re-emergence of many forgotten extrapulmonary manifestations of TB including oral TB, which must be taken into consideration while diagnosing oral lesions. The present article discusses the geographical burden, temporal evolution, demographic variables, clinical presentation and treatment of oral TB. The occurrence is most commonly secondary to pulmonary TB but oral symptoms may precede systemic symptoms. The most common presentation is ulceration (71%) and histopathological specimens demonstrate the characteristic epithelioid and langhans cells. In a unique case, presented here, an ulcerative tuberculous gingival lesion demonstrated dense plasma cell infiltration histologically and closely mimicked plasma cell gingivitis which made the diagnosis challenging.

Head and neck tuberculosis: Literature review and meta-analysis.

BACKGROUND: Head and neck tuberculosis (HNTB), including cervical lymphadenopathy, is the most common extrapulmonary manifestation of TB. The proposed study investigated the epidemiologic and clinical characteristics of HNTB. MATERIALS AND METHODS: A literature search was conducted via PubMed, Embase, Cochrane Library and Wanfang for keywords (tuberculosis, head and neck, laryngeal, pharyngeal, tongue, oropharyngeal, nasopharyngeal, and oral cavity). Scientific articles published from January 1990 through July 2017 were selected and reviewed to assess the epidemiology, presentation, diagnosis and treatment of HNTB disease. RESULTS: Results from the included 57 studies revealed that the majority of HNTB cases were age<40 years and female. The most common HNTB sites were cervical lymph nodes (87.9%), followed by larynx (8.7%). Involvement of other HN-regions was rare (3.4%). Multidrug resistant TB was not common among the majority of studies. Given the paucibacillary nature of HNTB, sputum tests did not have a good performance on HNTB diagnosis. Most of HNTB cases were diagnosed by fine-needle aspiration, cytology and excision biopsies in combination with clinical presentations. CONCLUSION: HNTB disease is an important manifestation in the diagnostic process in an otolaryngologist practice. The developments of rapid, ultrasensitive, simple and cost-effective high-throughput methods for early diagnosis of HNTB are urgently needed.

Head and neck tuberculosis in KwaZulu-Natal, South Africa.

OBJECTIVE: To describe the clinical features of head and neck tuberculosis in KwaZulu-Natal, South Africa. STUDY DESIGN: Retrospective, observational study. METHOD: The study included 358 patients who received a histopathologically and/or microbiologically confirmed diagnosis of tuberculosis in the head and neck region between 1 January 2007 and 31 December 2011. RESULTS: A total of 358 new cases of head and neck tuberculosis were identified during the study period, involving 196 males (54.7 per cent) and 162 females (45.3 per cent). These patients had a median age of 31 years (range, 3 months to 83 years). Testing for human immunodeficiency virus was positive in 233 (65.1 per cent) and negative in 125 (34.9 per cent). Right-sided cervical lymphadenitis was the commonest form of presentation of head and neck tuberculosis. CONCLUSION: In this study, right-sided cervical lymphadenopathy was the commonest presentation of head and neck tuberculosis in both human immunodeficiency virus infected and non-infected individuals. Head and neck tuberculosis should not be excluded solely based on a normal chest X-ray, nor on the absence of constitutional symptoms.

Prevalence of oral lesions in Brazilian patients with tuberculosis.

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.

Mycobacterial tuberculosis superimposed on a Warthin tumor.

The concomitant occurrence of tuberculosis infection within a Warthin tumor is extremely rare, as only 6 cases have been previously reported in the English-language literature. We report a new case in a 92-year-old man, who presented with a 20-year history of a painless swelling in the right infra-auricular area that had recently become painful and larger. The patient had no history of tuberculosis, weight loss, or chronic cough. The fluctuant mass was aspirated, but histopathology and routine culture were negative. Computed tomography identified a 5-cm, heterogeneous, enhancing mass with multiple, variably sized, low-density areas without surrounding edema in the area of the right parotid gland. Complete excision was performed to relieve the patient's symptoms. Histopathology diagnosed an acid-fast bacillus infection within a Warthin tumor. On polymerase chain reaction testing, formalin-fixed, paraffin-embedded tissue was negative for tuberculosis, but subsequent culture identified Mycobacterium tuberculosis. Initially, the patient refused antituberculosis therapy, but he relented when miliary pulmonary tuberculosis was diagnosed 11 weeks postoperatively.

Global oral health inequalities: oral infections-challenges and approaches.

Four oral mucosal infections were identified as Global Oral Health Priorities: (a) HIV and associated viral, bacterial, and fungal infections; (b) tuberculosis; (c) NOMA; and (d) sexually transmitted diseases. Huge global inequalities exist in all four. HIV-associated infections constitute the major challenge. Oral manifestations of AIDS can be specifically diagnostic, indicating a significant role for dentists within health teams. The World Workshops in Oral Health & Disease in AIDS have identified a research program, elements of which are being implemented. Data on oral mucosal involvement in tuberculosis, syphilis, and gonorrhea are incomplete in developed countries and virtually non-existent in low- and middle-income countries, indicating the need for further epidemiological studies. Oral manifestations of tuberculosis and sexually transmitted diseases are largely associated with general health, so action programs should be integrated with agencies treating the systemic diseases. NOMA is very much in the oral health domain. It is a preventable disease associated with malnutrition and unidentified bacterial factors. Prevalence is probably grossly overestimated at present; but nevertheless it constitutes a challenge to the profession, especially in the NOMA belt. Current treatment is surgical, but plans for its eradication should be achievable. The global oral health community, especially the IADR, has a major role to play.

Rol del odontólogo ante el avance de la tuberculosis / The dentist´s role to the advance of tuberculosis

El presente trabajo pretende concientizar a la comunidad odontológica sobre el aumento de la incidencia de tuberculosis (TB) en las últimas décadas, asociado al VIH/SIDA, a las migraciones y al desarrollo de cepas bacterianas resistentes a los fármacos que se emplean habitualmente para su tratamiento. En la actualidad, es un problema de salud en el mundo, que se ve incrementado en los países en desarrollo. El agente causal es el Mycobacterium tuberculosis que puede involucrar distintas localizaciones, aunque la mayoría es TB pulmonar. La TB bucal es poco frecuente y típicamente sigue a la TB pulmonar. La profesión odontológica desempeña unpel importante en su identificación y control, tanto por el reconocimiento temprano de las lesiones bucales primarias, como de aquellos que pueden ayudar a descubrir casos activos de TB pulmonar. Los odontólogos pueden ser los primeros profesionales de la salud en detectar a un paciente enfermo. La odontología es una profesión con elevado riesgo ocupacional, que debe respetar las normas de bioseguridad durante la atención de pacientes a fin de minimizar los riesgos de contagio.

Tuberculosis of the oral cavity: a systematic review.

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.

A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK.

AIMS: To analyse the epidemiology, presentation and diagnosis of head and neck tuberculosis (TB). METHODS: We conducted a 10-year retrospective study of all cases of tuberculosis of the head and neck region occurring in Bradford, UK. RESULTS: Of a total of 1315 cases of TB, 128 presented with head and neck TB (12 per cent of which (15/128) were in children). Cervical lymph nodes were most commonly involved (87 per cent, 111/128), other sites being: salivary glands (five cases); larynx, oral cavity, eyes and ears (two cases each); and skin, thyroid, nasopharynx and retropharyngeal space (one case each). Patients' ethnic origins were Asian (89 per cent, 114/128), Caucasian (10 per cent, 13/128) and African (one case). Only 26 per cent (33/128) had constitutional symptoms, and 20 per cent (25/128) had a coexistent site of TB. Only 39 per cent (40/105) of surgical specimens were sent for culture. CONCLUSIONS: Isolated head and neck TB is not uncommon. Atypical presentations render diagnosis challenging, so awareness aids early diagnosis. Mycobacterial cultures should be performed, where possible, for diagnosis.

Tuberculous otitis media: report of 2 cases on Long Island, N.Y., and a review of all cases reported in the United States from 1990 through 2003.

We report 2 cases of tuberculous otitis media that were diagnosed at Stony Brook University Hospital in New York since 1999. Both patients were women, aged 30 and 31 years. One patient had grown up in Russia, the other was a native-born American who had never left the East Coast region of the United States. Both patients had been symptomaticfor many months; one complainedof chronic otorrhea, and the other reported otorrhea, hearing loss, and discomfort. Neither patient responded to medical management, and both ultimately underwent surgery. One was diagnosed after surgical pathology revealed acid-fast bacilli on frozen-section analysis. In the other, pathology revealed chronic inflammation and granulomata, butstains were negative and her diagnosis was delayed for almost 2 years. We also review 9 other cases of tuberculous otitis media in the United States that have been reported in the literature since 1990. Our review suggests that the number of cases is rising in areas where tuberculosis is most common--that is, in major U.S. cities. Although 3 of these 9 cases occurred as reactivation disease in immigrants, most might have occurred as a result of local transmission. Clinicians should maintain a high degree of suspicion for tuberculosis in patients with chronic otitis symptoms, particularly those who are at higher risk of exposure to tuberculosis.

Oral fungal and bacterial infections in HIV-infected individuals: an overview in Africa.

Oral opportunistic infections developing secondary to human immunodeficiency virus (HIV) infection have been reported from the early days of the epidemic and have been classified by both the EC-Clearinghouse and the World Health Organisation (WHO). Among the fungal infections, oral candidiasis, presenting in African HIV-infected patients has been sporadically documented. We review the literature with respect to candidal carriage, oral candidiasis prevalence and the predictive value of oral candidiasis for a diagnosis of underlying HIV disease in African HIV-infected patients. The use of oral candidiasis as a marker of disease progression, the species of yeasts isolated from the oral cavity in Africa and the resistance of the yeasts to antifungal agents and treatment regimens are discussed. Orofacial lesions as manifestations of the systemic mycoses are rarely seen in isolation and few cases are reported in the literature from Africa. In spite of the high incidence of noma, tuberculosis, chronic osteomyelitis and syphilis in Africa, surprisingly there have been very few reported cases of the oral manifestations of these diseases in HIV-positive individuals. Orofacial disease in HIV-infected patients is associated with marked morbidity, which is compounded by malnutrition. The authors indicate specific research areas, initially directed at the most effective management strategies, which would complete data in this important area.

Tuberculosis de la glándula submaxilar: aportación de dos casos clínicos / Tuberculosis of the submandibular gland: report of two clinical cases

Exponemos dos casos diagnosticados primariamente como sialoadenitis y que, posteriormente, resultaron ser una tuberculosis de la glándula submaxilar. Esta afeccón se presentea con una semiología inespecífica similar a una sialolitiasis. Aunque es más frecuente en nuestro medio la Tbc ganglionar que la glandular, debemos tener siempre presente que ante una adenopatía cervical habrá que descartar esta patología y que el diagnóstico definitivo lo vamos a realizar, tras la cirugía, con el examen anatomopatológico y bacteriológico. La PAAF junto con el test de Mantoux pueden ayudarnos en el diagnóstico prequirúrgico de la enfermedad

Oral manifestations associated with human immunodeficiency virus infection in a Spanish population.

A study was made of the oral manifestations in 396 patients with human immunodeficiency virus (HIV) infection. The following risk groups were established: intravenous drug users (79.5%), homosexuals (7.8%), homosexual intravenous drug users (3.3%), heterosexuals (8.1%) and hemophiliacs/transfusion patients (1.3%). The oral lesions, in decreasing order of frequency, were: periodontal disease (78.28%), candidiasis (65.65%), hairy leukoplakia (16.16%), herpes simplex virus lesions (5.30%). Kaposi's sarcoma (2.27%), recurrent aphthous ulceration (RAS) (1.01%), lichen planus (0.5%), non-Hodgkin's lymphoma (0.25%), tuberculous lesion of the tongue (0.25%) and ulcerations of uncertain etiology (0.25%). Attention is drawn to the greater predominance of these lesions in patients with CD4 values of less than 200/ mm3, compared with those who have higher lymphocyte counts.

[Tuberculosis of the otorhinolaryngologic region: laryngeal and extra-laryngeal forms]. / Tuberculosis del área otorrinolaringológica: formas laríngeas y extralaríngeas.

BACKGROUND: The aim of the study was to assess all patients with ENT symptoms whose histologic and/or microbiologic diagnosis confirmed tuberculosis. METHODS: All the anatomopathologic studies performed in the ENT unit in the authors' hospital in which the presence of acid-alcohol resistant bacilli were observed. All cases of cervical adenitis were not included. RESULTS: Eighteen patients with the following localizations were studied: 14 laryngeal tuberculosis and 4 extra-laryngeal tuberculosis (2 oropharyngeal, 1 otic and 1 sinusal). In the laryngeal forms, all patients were male except for one, and all were smokers. The duration of the symptoms was greater than 3 months in all the cases. Unilateral cord involvement was most commonly found, and in 2 cases this was associated with carcinoma of the vocal cord. Twenty-nine percent did not present with coincident pulmonary tuberculosis. None of the extra-laryngeal forms showed pulmonary involvement. All the patients were women and only 1 was smoker, the symptomatology was greater than 3 months in all cases and all required biopsy for achieving diagnosis. The evolution with medical treatment was favorable in all cases. During the same time period, 2300 cases of pulmonary tuberculosis were diagnosed in the authors' hospital. CONCLUSIONS: Tuberculosis of the upper respiratory tract is infrequent. Pulmonary involvement is common, although in this series this was only found in 71% of all laryngeal forms. Diagnosis is difficult, except in cases of coinciding pulmonary involvement and usually requires surgery for biopsy. Response to medical treatment is usually good.