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.

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.

A case report of a tongue ulcer presented as the first sign of occult tuberculosis.

BACKGROUND: Tuberculosis (TB) is a serious infectious disease with considerable fatality, typically affecting the pulmonary system and, rarely, other body organs including the oral cavity. Due to the rarity of oral TB, it is frequently overlooked in differential diagnosis of oral lesions. Despite a declining trend in TB incidence in recent years, it is still a major public health problem with high contagiousness, thereby requiring the early diagnosis and prompt treatment. CASE PRESENTATION: A 57-year-old male patient presented with chief complaint of painful ulcer on tip of his tongue. He reported that the ulcer developed without any remarkable event such as mechanical trauma, vesicle formation or systemic illness. His past medical history revealed the TB over 40 years ago, which had reportedly healed after pharmacological treatments. As the ulceration persisted after topical steroid application and careful education about avoiding possible mechanical stimuli, biopsy was performed and histological finding showed typical findings of oral tuberculosis including intense granulomatous inflammatory features with small red rods of mycobacterial organisms as well as epithelioid cells and Langhans giant cells. After suitable antituberculosis treatments, oral tuberculosis ulcer was almost completely healed. We present a case of oral TB affecting tip of the tongue in a patient with a history of pulmonary TB and emphasize the understanding of intraoral manifestations for early diagnosis and prompt treatment of TB. CONCLUSIONS: The present case represented the importance of understanding oral tuberculosis manifestations for dental clinicians who might be frequently the first health care professionals to encounter various oral lesions.

Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass.

An 80-year-old woman presented with dysphagia, odynophagia and progressive weight loss. Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis Closer inspection of the patient's medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck.

Primary Tuberculosis of Tongue.

Tuberculosis is a granulomatous disease caused by mycobacterium.1-3 The lung is the most common site of involvement, and it is very rare to involve the oral cavity.1,2 Most of the tuberculous lesions of oral cavity are secondary to lung disease, usually seen in elderly patients.1 Primary tuberculosis of the oral cavity is rare and is most commonly found in children and adolescents rather than in adults.1,2 Among them tuberculosis of tongue is very rare. Here we report a first case of our hospital with primary tuberculosis of tongue in a 55-year-old male from Madhya Pradesh.

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.

Tuberculosis of the Cheek: A Rare Presentation.

Tuberculosis (TB) typically attacks the lungs. The oral lesions either primary or secondary are rarely seen and often overlooked by the clinician. More so, their atypical presentations make the diagnosis challenging; especially when they are present before the systemic symptoms become apparent. We report a case of primary tuberculosis in a 4 year old female child in a very uncommon location, the cheek. The timely diagnosis and antitubercular therapy resulted in complete resolution of the swelling within 6 months.

Tuberculosis of the parotid gland: histology surprise.

The Parotid gland is rarely involved in tuberculosis, even in endemic countries. We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge. Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution. We discuss both diagnostic and therapeutic modalities for this infection.

Tuberculosis of the oral cavity.

Tuberculosis (TB) of the tongue is not a common finding diagnosis, even if consider endemic areas. Tuberculosis of the tongue sometimes can mimic lingual neoplasm. Oral tuberculosis is rarely primary as mechanism, and frequently secondary to pulmonary tuberculosis. There are many suspect lesions that can be classified as tuberculosis, such as tumor mass, ulcerative lesion or fissure. It is very important for diagnosis to perform histopathological examination of the biopsy. We present here the case of a 74-year-old man who developed lingual tuberculosis with a tumor aspect concomitant with pulmonary tuberculosis. Histopathological and immunohistochemical examinations established the diagnosis of lingual tuberculosis.

Tuberculosis: oral alveolus and pulmonary alveoli coexisting.

Tuberculosis of the oral cavity is uncommon in this antibiotic era. We report a case of a long standing non-healing ulcer of the right upper maxillogingival sulcus, found to be tuberculosis of a rather unusual site in the oral cavity, the alveolus.

Intraductal pressure during sialendoscopy.

BACKGROUND: Sialendoscopy can be followed by swelling and infection of the salivary gland. A possible pathomechanism is damage of the deeper salivary duct system by intraductal pressure generated by the irrigation fluid. METHOD: After measuring the physiological intraductal pressures which arise during sialendoscopy, these pressures were simulated in freshly excised salivary glands and the tissue was analysed histologically. RESULTS: Normal intraductal filling pressure during sialendoscopy is 100-250 daPa, and pressure peaks can be up to 2000 daPa during flushing. A filling pressure of more than 400 daPa results in dilatation of the salivary ducts and acinar area. No direct damage to any duct structures could be observed histologically. CONCLUSION: Irrigation fluid should be administered intermittently rather than continuously during sialendoscopy. The intraductal filling pressure should not exceed 400 daPa to minimise the trauma to the salivary duct system and reduce the risk of developing oedema and inflammation.

Primary tuberculosis of the palate.

Tuberculosis (TB) is a life-threatening infectious disease with a high world incidence. However, TB with oral expression is considered rare. The importance of recognising this entity lies in its early diagnosis and treatment, as it can be easily confused with neoplastic or traumatic ulcers. We present a case of a primary TB located in the hard palate and gingiva in an 88-year-old woman.

[Primary mucosal tuberculosis of head and neck region: a clinicopathologic analysis of 47 cases].

OBJECTIVE: To study the clinicopathologic features, histologic diagnosis and differential diagnosis of primary mucosal tuberculosis (TB) in the head and neck region. METHODS: Forty-seven cases of primary mucosal TB of the head and neck region were studied by hematoxylin-eosin and Ziehl-Neelsen stains. The clinical and pathologic features were analyzed with review of the literature. RESULTS: The patients included 26 male and 21 female, with mean age 47.1 years (range 14-84 years). There were three sinonasal TB, 19 nasopharyngeal TB, two oropharyngeal TB, 18 laryngeal TB, four middle ear TB, one salivary gland TB and one laryngeal TB complicating laryngeal cancer. The initial symptoms were nasal obstruction, mucopurulent rhinorrhea, epistaxis, snoring, hoarseness, dysphagia, odynophagia, serous otitis, hearing loss, tinnitus, and otalgia. Physical examination result was variable, from an apparently normal mucosa, to an evident mass, or a mucosa with an adenotic or swollen appearance, ulcers, leukoplakic areas, and various combinations thereof. CT and MRI findings included diffuse thickening, a soft-tissue mass, calcification within the mass and bone destruction resembling malignancy. Histologic examination showed granulomas with a central necrotic focus surrounded by epithelioid histiocytes and multinucleated Langhan's giant cells. Acid-fast bacilli were difficult to demonstrate but found in 13/45 cases. Follow-up data were available in 42 patients. CONCLUSIONS: Primary TB arising in the head and neck mucosa is rare. It may mimic or co-exist with other conditions. The characteristic histopathology is a granuloma with central caseous necrosis and Langhans'giant cells. Identification of acid-fast bacilli and bacteriologic culture confirm the diagnosis of mycobacterial disease.

Disguised ulcer of lip and buccal mucosa – rare clinicalmanifestation as tuberculosis: a case report / Úlcera de mucosa labial e bucal – uma rara manifestação clínica detuberculose: relato de caso clínico

Introduction: Oral tuberculosis is a chronic granulomatous disease caused by Mycobacterium tuberculosis. According to the World Health Organization (WHO), nearly 2 billion people are infected with tuberculosis. Objective: To report a rare case of oral tuberculosis with ulcers at two different sites. Materials and methods: In order to emphasize the need to consider tuberculosis in the differential diagnosis of non-healing ulcers of oral cavity and the role of oral physician in preventing the spread of such lesions, this article presents a case of oral ulcers at two different sites, diagnosed as tuberculosis ulcer. Results: Oral cavity, which is considered to be a mirror of systemic health, rarely manifests tuberculosis. With increasing number of tuberculosis cases and unusual form of the disease in the oral cavity, the cases are likely to be misdiagnosed. Conclusion: An oral clinician should have a thorough knowledge of tuberculosis and its oral manifestations.

Introdução: A tuberculose oral é uma doença granulomatosa crônica causada pelo Mycobacterium tuberculosis. Segundo a Organização Mundial da Saúde (OMS), cerca de 2 bilhões de pessoas estão infectadas com tuberculose. Objetivo: Relatar um caso raro de tuberculose oral com úlceras em dois locais diferentes. Materiais e métodos: Para realçar a necessidade de considerar a tuberculose sob o diagnóstico diferencial das úlceras não curadas da cavidade oral e o papel do dentista na prevenção da propagação de tais lesões, este artigo apresenta um caso de úlceras orais em dois locais diferentes, diagnosticados como úlcera de tuberculose. Resultados: A cavidade oral, considerada como um espelho da saúde sistêmica, raramente manifesta a tuberculose. Com um número cada vez maior de casos de tuberculose e a forma não usual da doença na cavidade oral, os casos são frequentemente diagnosticados erroneamente. Conclusão: O dentista clínico geral deve ter um conhecimento profundo da tuberculose e de suas manifestações orais.

Tuberculosis cutis orificialis (TBCO): a rare manifestation of tuberculosis.

Tuberculosis of the oral cavity is a very rare disease and accounts for less than one percent of all cases of tuberculosis. Primary lesions are extremely rare. Presentation is as a single ulcer, may be painful, however multiple painless ulcers have been described. Tongue is the most common oral site involved. The palate, buccal mucosa, floor of the mouth, gingiva, and lips are other possible sites. We hereby report a case of TBCO, a very rare manifestation of tuberculosis.