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Salvi GE, Roccuzzo A, Imber JC, Stähli A, Klinge B, Lang NP. Clinical periodontal diagnosis. Periodontol 2000 2023. [PMID: 37452444 DOI: 10.1111/prd.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 07/18/2023]
Abstract
Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Malinvaud D, Shenouda K, Laccourreye L, Guiquerro S, Rubin F, Laccourreye O. Aural tuberculosis at the start of the 21st century. Literature review according to SWiM guidelines. Part 2: Treatment. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:351-356. [PMID: 35778340 DOI: 10.1016/j.anorl.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Systematic review of the scientific literature dedicated to treatment modalities and results for aural tuberculosis published since the start of the 21st century. MATERIAL AND METHODS Search of the Medline, Cochrane and Embase databases for the period 2000 - 2020. Selection of articles in English, French and Spanish devoted to clinical cases and series documenting treatment of auricular tuberculosis. Extraction of data on pre-established files documenting treatment modalities and results. Reading of articles by two authors. Analysis performed according to SWiM guidelines, evaluating cure, tuberculosis-related death, treatment-related complications, improvement in facial palsy, and hearing sequelae rates. RESULTS One hundred and twenty eight articles: 118 case reports (159 patients) and 10 cohorts (177 patients) from 42 countries were analyzed. Female/male sex ratio was 1.2 with ages ranging from 1 month to 87 years. Medical treatment consisted in 5 to 24 months' antitubercular antibiotic treatment using 2 to 8 antibiotics. Mastoidectomy, tympanoplasty and facial nerve decompression were associated to medical treatment in 64.7%, 17.4% and 6.2% of cases, respectively. Overall rates of cure, death, treatment-related complications, facial sequelae and hearing sequelae were 96.8%, 2%, 9.5%, 35.8% and 75.5%. In case reports, BCG vaccination did not appear to protect against facial palsy and severe intracranial complications (P>0.6). There was no significant correlation (P>0.3) between death and the clinical variables tested, and facial nerve decompression did not appear to influence outcome for facial function (P=0.4). CONCLUSION Medical treatment is very effective but not without risk of death, complications and sequelae. It is the same as for pulmonary tuberculosis. Indications for and benefit of major auricular surgery during medical treatment deserve further studies.
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Affiliation(s)
- D Malinvaud
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, Assistance Publique des hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France; Unité CNRS UMR 8002, INCC - Integrative Neuroscience and Cognition Group, France
| | - K Shenouda
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, Assistance Publique des hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France
| | - L Laccourreye
- Institut Arthur Vernes, service d'Otorhinolaryngologie et de chirurgie cervico-faciale, 36 rue D'Assas, 75006, Paris, France
| | - S Guiquerro
- Université Paris Cité, bibliothèque universitaire Necker, 160 rue de Vaugirard, 75015, Paris, France
| | - F Rubin
- Clinique St-Vincent, 8, rue de Paris, CS 71027, Saint-Denis Cedex 97404, La Réunion, France
| | - O Laccourreye
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, Assistance Publique des hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
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Moisa SM, Miron I, Adam-Raileanu A, Lupu VV, Lupu A, Tarca E. Primary tonsillar tuberculosis in a pediatric patient: Case report and literature review. Medicine (Baltimore) 2021; 100:e27616. [PMID: 34871225 PMCID: PMC8568445 DOI: 10.1097/md.0000000000027616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Tuberculosis is an entity that usually affects the lungs, although extrapulmonary sites can also be involved. Tonsils are rarely affected, especially in the absence of pulmonary disease, primary tonsillar tuberculosis being a diagnostic challenge for the clinician. PATIENT CONCERNS We present the case of a 14-year-old female teenager, presented to our Pediatric Service with a 14-day history of dysphagia, odynophagia and left reflex otalgia associated with a 5 kg weight loss. Clinical examination revealed mild pharyngeal erythema, marked enlargement of the left tonsil infiltrating the lateral pharyngeal wall and the uvula and painful, mobile, nonadherent to deep bilateral latero-cervical adenopathy. DIAGNOSIS Positive interferon-gamma release assay (QuantiFERON-TB gold). Mantoux test reading was 16 mm. INTERVENTIONS During hospitalization, the patient received Clindamycin and Gentamicin for 3 days i.v., with discrete relief of symptoms and inflammatory markers. On the 4th day of hospitalization, treatment with Imipenem/Cilastin is started for 7 days in micro-perfusion, with tonsil hypertrophy decrease in size and favorable clinical evolution. OUTCOME Tonsil hypertrophy decreased in size and patient had a favorable clinical evolution. At discharge, the patient was given a 6-month course of anti-tuberculous drug. LESSONS The particularity of this case is represented by the rarity of primary tuberculosis of tonsils in children, with unilateral involvement, displaying at the same time a common issue encountered in the current practice: the limitations and the difficult course of setting the diagnosis due to the involvement of relatives in the medical act.
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Bandara HMHN, Samaranayake LP. Viral, bacterial, and fungal infections of the oral mucosa: Types, incidence, predisposing factors, diagnostic algorithms, and management. Periodontol 2000 2019; 80:148-176. [PMID: 31090135 DOI: 10.1111/prd.12273] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
For millions of years, microbiota residing within us, including those in the oral cavity, coexisted in a harmonious symbiotic fashion that provided a quintessential foundation for human health. It is now clear that disruption of such a healthy relationship leading to microbial dysbiosis causes a wide array of infections, ranging from localized, mild, superficial infections to deep, disseminated life-threatening diseases. With recent advances in research, diagnostics, and improved surveillance we are witnessing an array of emerging and re-emerging oral infections and orofacial manifestations of systemic infections. Orofacial infections may cause significant discomfort to the patients and unnecessary economic burden. Thus, the early recognition of such infections is paramount for holistic patient management, and oral clinicians have a critical role in recognizing, diagnosing, managing, and preventing either new or old orofacial infections. This paper aims to provide an update on current understanding of well-established and emerging viral, bacterial, and fungal infections manifesting in the human oral cavity.
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Affiliation(s)
| | - Lakshman P Samaranayake
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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5
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Head and neck tuberculosis: Literature review and meta-analysis. Tuberculosis (Edinb) 2019; 116S:S78-S88. [DOI: 10.1016/j.tube.2019.04.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 12/13/2022]
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Gondivkar S, Gadbail A, Sarode GS, Sarode SC, Patil S, Awan KH. Infectious diseases of oral cavity. Dis Mon 2018; 65:164-184. [PMID: 30681961 DOI: 10.1016/j.disamonth.2018.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Shailesh Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Amol Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram nagar, Pimpri, Pune 411018, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Sant-Tukaram nagar, Pimpri, Pune 411018, Maharashtra, India.
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Kamran H Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, United States
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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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Abstract
Upper respiratory tract involvement in cases of tuberculosis (TB) of the head and neck continues to be described in the most recent reports from several different regions, including some from developed countries. Laryngeal TB is the most common of all forms of upper respiratory tract TB (URT-TB). Pulmonary lesions in URT-TB are present in about 20% of adults and about 50 to 60% of children. Systemic manifestations are uncommon. URT-TB is especially seen in patients with a variety of risk factors, such as the presence of human immunodeficiency virus (HIV) infection, diabetes, smoking, alcoholism, drug abuse, malignancies, and use of immunosuppressive drugs. Nodules or ulcerative lesions are seen on morphological examination. Endoscopic examination is required for mucosal lesions. Diagnosis of TB is suspected on an epidemiological basis in high-prevalence countries or from the failure of a patient to respond to routine treatment. Smear and/or histopathological examinations help in establishing the final etiological diagnosis. Treatment includes standard anti-TB chemotherapy for at least 6 months with four primary drugs during the initial intensive phase of 2 months and two or three primary drugs during the remaining maintenance phase of 4 months. Treatment is modified on the basis of culture and sensitivity reports in cases of suspected drug resistance. Surgical intervention may be required for some patients with abscess formation and progressive disease unresponsive to medical therapy. Airway obstruction, although rare, even in fulminant cases may require tracheostomy for relief.
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9
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A rare case of chronic otitis externa due to Mycobacterium tuberculosis. J Clin Tuberc Other Mycobact Dis 2017; 8:13-15. [PMID: 31723705 PMCID: PMC6850261 DOI: 10.1016/j.jctube.2017.05.001] [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] [Received: 10/22/2016] [Revised: 05/13/2017] [Accepted: 05/15/2017] [Indexed: 11/21/2022] Open
Abstract
Chronic otitis externa due to Mycobacterium tuberculosis complex is extremely rare and very few cases have been presented in the medical literature. We report here the case of an immunocompetent 68-year-old male with chronic auricular drainage, otalgia, hearing loss, external ear canal and tympanic membrane thickening for 3 years who was ultimately diagnosed with tuberculous chronic otitis externa on biopsy of external auditory canal granulation tissue using molecular diagnostic techniques. Later, sputum cultures were positive for Mycobacterium tuberculosis complex indicating disseminated tuberculosis. However, two plausible explanations could be pulmonary TB that disseminated to the ear canal with evidence of middle and outer otitis, or upper airway/nasopharyngeal involvement with direct extension into the middle and outer ear canals. Although extremely rare, extrapulmonary laryngeal head and neck tuberculosis should be considered in immunocompetent patients who present with chronic otitis without prior known exposure to tuberculosis when they fail standard therapy and in whom no other microbiologic cause can be identified.
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10
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Kryukov AI, Garov EV, Ivoilov AY, Shadrin GB, Sidorina NG, Lavrova AS. [The clinical manifestations and diagnostics of otitis media caused by tuberculosis]. Vestn Otorinolaringol 2015; 80:28-34. [PMID: 26288206 DOI: 10.17116/otorino201580328-34] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of the present study was to clarify the characteristic pathognomonic features of middle ear lesions associated with tuberculosis and the approaches to their diagnostics under the present-day conditions. The study included 11 cases (18 ears) of tuberculosis otitis media and the related lesions of the mastoid process diagnosed with the use of clinical, roentgenological, cytological, bacteriological, pathomorphological, and molecular-genetic methods (including PCR diagnostics). The primary localization of tuberculosis in the middle ear was documented in 6 patients; in 5 patients, it was associated with pulmonary involvement. Five patients presented with smoldering exudative otitis media and the remaining six ones with suppurative perforating otitis media. The tuberculous process was diagnosed with the use of various methods including clinical examination, bacteriological (9%), cytological (27.3%), pathomorphological (18%) studies, and PCR diagnostics (55%). Diagnosis was made within a period from 1 month to 1.5 years after the application of the patients for medical assistance which suggests the difficulty of verification of tuberculous etiology of the disease of the middle ear. It is concluded that the high index of suspicion in the case of smoldering middle ear pathology facilitates its early diagnostics and successful treatment.
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Affiliation(s)
- A I Kryukov
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - E V Garov
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A Yu Ivoilov
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - G B Shadrin
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - N G Sidorina
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - A S Lavrova
- L.I. Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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11
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Jain P, Jain I. Oral Manifestations of Tuberculosis: Step towards Early Diagnosis. J Clin Diagn Res 2014; 8:ZE18-21. [PMID: 25654056 DOI: 10.7860/jcdr/2014/10080.5281] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 09/10/2014] [Indexed: 11/24/2022]
Abstract
Tuberculosis, as known universally, is a chronic infectious disease that can affect any part of the body including mouth. It usually affects the lungs, TB bacilli can spread hematogenously to other parts of the body and this also includes mandible or maxilla. It can occur in the mouth involving the tongue with very unusual features and forms. So oral lesions, although rare, are very important for early diagnosis and interception of primary tuberculosis.
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Affiliation(s)
- Pankaj Jain
- Reader, Department of Oral Pathology, ITS Dental College , Ghaziabad, UP, India
| | - Isha Jain
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, ITS Dental College , Ghaziabad, UP, India
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12
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Lmekki S, Lecanu JB. Tuberculosis of the middle ear and nasal passage: A case report. Int J Mycobacteriol 2013; 2:51-3. [PMID: 26785789 DOI: 10.1016/j.ijmyco.2013.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 01/10/2013] [Accepted: 01/13/2013] [Indexed: 11/25/2022] Open
Abstract
The following report highlights the case of a 55-year-old female with nasal and middle ear tuberculosis. The diagnosis was confirmed using imagery, histopathological biopsy reports, and Polymerase chain reaction (TB-PCR). The patient was treated with rifampicin (10mg/kg), isoniazid (5mg/kg) and pyrazinamide (25mg/kg) for 9months. No recurrence was observed after one year of follow-up examination. Both nasal tuberculosis and tuberculous otitis media are currently considered rare diseases, yet if they are evaluated rapidly, there will be a good response to therapy without the need for surgery.
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Affiliation(s)
- Safaa Lmekki
- N°2 Résidence Ghita, rue Kamal Oudouane, ville nouvelle Fes 30000, Morocco.
| | - Jean Baptiste Lecanu
- Department d'O.R.L. et de chirurgie cervico-faciale, Institut Arthur Vernes 36, rue d'Assas, 75006 Paris, France
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Markowski J, Witkowska M, Gierek T, Pasternak K, Ciupińska-Kajor M, Kajor M, Paluch J, Smółka K. [Head and neck tuberculosis - still current problem in ENT practice]. Otolaryngol Pol 2011; 65:272-5. [PMID: 22000144 DOI: 10.1016/s0030-6657(11)70689-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 05/26/2011] [Indexed: 11/17/2022]
Abstract
INTRODUCTION It is estimated that between XVI and XIX century one fourth of European population died of tuberculosis. Nowadays tuberculosis is still one of the most important infectious diseases. In 2009 estimately 9 million new cases were registered worldwide, mortality due tuberculosis reached 1.5 million. In Poland extrapulmonary tuberculosis is rare (7% of overall morbidity) and most commonly affects pleura, lymph nodes, bones, joints and genitourinary system. Head and neck tuberculosis is rare and causes many diagnostics problems. METHODS Retrospective analysis of case histories of patients admitted to ENT Department of Silesian Medical University in Katowice. RESULTS Between 1993 and 2010 four cases of head and neck tuberculosis were diagnosed in our Clinic. Two of patients were admitted to the hospital with symptoms of laryngeal tumor such as difficulty in swallowing. During direct laryngoscopy tissue specimens were taken. Examination of the third patient showed tumor located below left angle of mandibule. During superficial parotidectomy tumor was removed. In the fourth registered case tuberculosis manifested as tumor of nasopharynx. In every case which is mentioned above pathology reports revealed epithelioid cell granulomas with caseous necrosis typical for tuberculosis. Patients underwent tuberculostatic treatment. CONCLUSION Rare occurrence and lack of characteristic symptoms of head and neck tuberculosis often lead to misdiagnosis. Histopathological examination is the most important diagnostic procedure. Microbiological examination is difficult in extrapulmonary tuberculosis, because of low concentration of pathogens in specimens. Tuberculostatic therapy is the leading method of treatment in every case of tuberculosis.
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Tuberculosis of the oral cavity affecting alveolus: a case report. Case Rep Dent 2011; 2011:945159. [PMID: 22567449 PMCID: PMC3335710 DOI: 10.1155/2011/945159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 05/25/2011] [Indexed: 11/17/2022] Open
Abstract
We report a first case of tuberculosis of oral cavity affecting the left alveolus from Nepal in a 63-year-old male who came to otorhinolaryngology outpatient department with a complaint of an ulcer in the oral cavity and pain in bilateral ear and throat. An ulcer measuring 1.8 cm in diameter with irregular friable margin and bleeding on touch was found in the left upper alveolar region of the oral cavity. Biopsy from the ulcer margin revealed histological features of necrotizing granulomatous lesion. Stain for acid fast bacilli was positive.
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Nair RG, Owotade FJ, Leao JC, Hegarty AM, Hodgson TA. Coinfections associated with human immunodeficiency virus infection: workshop 1A. Adv Dent Res 2011; 23:97-105. [PMID: 21441489 DOI: 10.1177/0022034511399916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The importance of opportunistic pathogens in HIV disease has been demonstrated from the onset of the epidemic. This workshop aimed to review the evidence for the role of oral microorganisms in HIV-related periodontal disease and HIV transmission and the effect of HIV therapy on periodontal disease. Despite being a common copathogen, tuberculosis seems to have limited oral presentation. The oral manifestations seem to have little impact on the individual and, once diagnosed, are responsive to chemotherapy. The participants debated the available evidence on the role of microorganisms and whether further research was warranted and justified. Although the effects of lipodystrophy on facial aesthetics may be profound and may markedly affect quality of life, there is no evidence to suggest a direct effect on the oral cavity. Though of interest to oral health care workers, lipodystrophy and associated metabolic syndromes were thought to be further investigated by other, more appropriate groups.
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Affiliation(s)
- R G Nair
- Oral Medicine, School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
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Kwon M, Choi SH, Chung JW. Roles of an anti-tuberculosis medication and surgery in patients with tuberculous otitis media. Acta Otolaryngol 2010; 130:679-86. [PMID: 20222848 DOI: 10.3109/00016480903311260] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The standard treatment for tuberculous otitis media (TOM) without complications consists of anti-tuberculosis (anti-TB) medication, with which we experienced good treatment outcomes. However, surgery is required for recovery of anatomy and hearing function. OBJECTIVE To determine the clinical characteristics of TOM that might optimize diagnosis and to evaluate the differences in clinical courses between patients treated with and without surgery. METHODS We analyzed 14 patients (16 ears) who had been diagnosed and treated for TOM. Radiologic findings, laboratory data, and audiometry results were also evaluated. Patients were divided into a chemotherapy group and a surgery group according to treatment modality. RESULTS Temporal bone CT (TBCT) showed total occupation of the tympanic cavity by soft tissue and little evidence of ossicular erosion. In the chemotherapy group, dry ears were obtained in all but one patient (14 ears) after treatment. Normalized tympanic membrane (TM) was found in 50% in the chemotherapy group and in 75% in the surgery group. The air-bone gap (ABG) changed from 40.3 +/- 2.5 dB to 47.0 +/- 19.2 dB in the chemotherapy group and from 35.2 +/- 7.6 dB to 30.2 +/- 11.4 dB in the surgery group. After treatment, ABG improved by > 10 dB in one ear in the chemotherapy group and in four ears in the surgery group.
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Affiliation(s)
- Minsu Kwon
- Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Hamouda S, Opsomer H, Delattre A, Thumerelle C, Flammarion S, Santos C, Deschildre A. [Tuberculous otitis media]. Med Mal Infect 2008; 38:608-11. [PMID: 18954947 DOI: 10.1016/j.medmal.2008.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Revised: 04/02/2008] [Accepted: 09/11/2008] [Indexed: 11/30/2022]
Abstract
Tuberculous otitis media is a rare disease. Its diagnosis is often made late. We report the case of a 13-year-old girl presenting with a right chronic otitis media and a massive and painful cervical adenitis. High resolution CT-scan revealed cervical and mediastinal adenitis associated with extensive lesions involving the middle ear, mastoid air cells, and sphenoidal bone. The diagnosis of tuberculous otitis media was made on a positive tuberculin skin test and on the identification of Mycobacterium tuberculosis in gastric juices. The young girl progressed well after 9 months of antituberculous chemotherapy.
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Affiliation(s)
- S Hamouda
- Unité de pneumologie et allergologie pédiatrique, département de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille cedex, France
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Gody JC, Kassa-Kelembho E, Bobossi-Serengbe G, Beyam EN, Bercion R. À propos d'un cas d'otite tuberculeuse primitive compliquée de méningoencéphalite au complexe pédiatrique de Bangui (République centrafricaine). Med Mal Infect 2006; 36:177-9. [PMID: 16580801 DOI: 10.1016/j.medmal.2006.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2005] [Accepted: 01/23/2006] [Indexed: 11/26/2022]
Abstract
The authors report a case of fatal tuberculous meningoencephalitis following chronic bilateral otitis media in a child. Mycobacterium tuberculosis was identified in the CSF and in the otitis secretions. There were no pulmonary tuberculosis signs, thus the tuberculous otitis was considered as primary. In high tuberculosis endemic areas like Central African Republic it is important to consider tuberculosis, in chronic otitis media resistant to non specific therapy, and to reinforce the immunization programs for children.
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Affiliation(s)
- J-C Gody
- Clinique médicale infantile du complexe pédiatrique, BP 607, Bangui, République centrafricaine.
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21
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Vaamonde P, Castro C, García-Soto N, Labella T, Lozano A. Tuberculous otitis media: a significant diagnostic challenge. Otolaryngol Head Neck Surg 2004; 130:759-66. [PMID: 15195064 DOI: 10.1016/j.otohns.2003.12.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study was undertaken to revise the diagnostic characteristics of tuberculous otitis media (TOM), a disorder that is often diagnosed late, leading to delay in specific treatment. STUDY DESIGN AND SETTING Retrospective study of a longitudinal series of 10 TOM patients over a 7-year period at an institutional referral center. RESULTS Most patients showed intractable otorrhea, moderately severe hearing loss, and necrotic eardrums with granulation tissue and single perforations. Multiple perforations, facial palsy, and cervical adenopathies were rare (<10% of patients). CT generally showed soft tissue involvement of the middle ear without bone erosion. The most effective laboratory test microbiological culture of exudate (diagnostic efficacy 71%). Specific antibiotic treatment was effective in all cases. CONCLUSION The diagnosis of TOM remains a significant challenge for otorhinolaryngologists. SIGNIFICANCE If there are strong clinical grounds for suspicion, standard laboratory tests for tuberculosis should be repeated even if initially negative.
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Affiliation(s)
- Pedro Vaamonde
- ENT Service, University Clinical Hospital of Santiago de Compostela, Spain.
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22
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Ilyas SE, Chen FF, Hodgson TA, Speight PM, Lacey CJN, Porter SR, Llyas SE. Labial tuberculosis: a unique cause of lip swelling complicating HIV infection. HIV Med 2002; 3:283-6. [PMID: 12444947 DOI: 10.1046/j.1468-1293.2002.00112.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND HIV disease has many oral manifestations including tuberculosis, which most commonly presents as irregular ulceration of the tongue or the palate. We detail an HIV-infected patient found to have tuberculosis of the lip. CONCLUSIONS To our knowledge tuberculosis of the lips has never been reported in conjunction with HIV infection, and in this case establishing the oral diagnosis resulted in the diagnosis of disseminated disease.
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Affiliation(s)
- S E Ilyas
- Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, London, UK
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