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MohanaSundaram A, Gohil NV, Etekochay MO, Patel P, Gurajala S, Sathanantham ST, Nsengiyumva M, Kumar S, Emran TB. Mycobacterium tuberculosis: A New Hitchhiker in the Etiopathogenesis of Periodontitis. Int J Surg 2024; 110:01279778-990000000-00969. [PMID: 38231241 PMCID: PMC11175725 DOI: 10.1097/js9.0000000000001122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024]
Abstract
Periodontitis, a chronic inflammatory disease of the gums affects both the ligament and alveolar bone. Severe form of periodontal disease affects a strikingly high number of one billion adults globally. The disease permutes both the soft and hard tissues of the oral cavity leading to localized and systemic diseases. Periodontitis has a deleterious impact on systemic health causing diabetes, cardiovascular diseases, and other disease. The cause of enhanced inflammatory process is due to dysbiosis and an unregulated immune response. Innate immune response and T cells trigger uninhibited cytokine release causing an unwarranted inflammatory response. The RANK- RANKL interaction between osteoblasts, immune cells and progenitor osteoclasts results in maturation of osteoclasts which promote bone resorption. It is well established that dysbiosis of the oral cavity has been implicated in periodontitis. But emerging reports suggest that pulmonary pathogen, Mycobacterium tuberculosis (Mtb), causes extra-pulmonary diseases such as periodontitis. Many clinical case reports advocate the involvement of Mtb in periodontitis which poses a threat with the surge of tuberculosis in HIV and other immunocompromised individuals. Fostering a better understanding of the mechanism, causative agents and control on inflammatory response is imperative in prevention and treatment of periodontitis.
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Affiliation(s)
| | | | | | | | - Swathi Gurajala
- College of Applied Medical Sciences in Jubail, Imam Abdulrahman bin Faisal University, Saudi Arabia
| | | | | | - Santosh Kumar
- Karnavati School of Dentistry Karnavati University Gandhinagar Gujarat, India
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, Bangladesh
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, Bangladesh
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2
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Aldrees AM, Alnajeim MH, Alomran AA, Alshehri AA. The Role of Therapeutic Drug Monitoring in Slow Response Extra-Pulmonary Tuberculosis Treatment: A Case Report. Cureus 2023; 15:e51301. [PMID: 38161565 PMCID: PMC10756859 DOI: 10.7759/cureus.51301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/03/2024] Open
Abstract
Tuberculosis is caused by an infectious bacterium and it has significant morbidity and mortality rates globally. It mostly affects the lungs, but it can also spread to other parts of the body, like the lymph nodes (tuberculous lymphadenitis). The most common way to treat it is with the RIPE regimen, which includes rifampin, isoniazid, pyrazinamide, and ethambutol. The drugs can be slowly or rapidly metabolized, resulting in either increased toxicity or subtherapeutic drug levels. In this paper, we discuss the case of a slow responder who was treated with increased rifampin and isoniazid doses and improved clinically and biochemically. It's the first case of a slow responder diagnosed with tuberculous lymphadenitis reported in the Gulf region.
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Affiliation(s)
- Abdulwahab M Aldrees
- Internal Medicine/Infectious Diseases, King Khalid University Hospital, Riyadh, SAU
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3
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Mocanu AI, Mocanu H, Moldovan C, Soare I, Niculet E, Tatu AL, Vasile CI, Diculencu D, Postolache PA, Nechifor A. Some Manifestations of Tuberculosis in Otorhinolaryngology - Case Series and a Short Review of Related Data from South-Eastern Europe. Infect Drug Resist 2022; 15:2753-2762. [PMID: 35668856 PMCID: PMC9166903 DOI: 10.2147/idr.s367885] [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: 03/25/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Tuberculosis is a disease of global outreach that may affect the entire human body but is most commonly located in the lungs. Otorhinolaryngological manifestations of tuberculosis are rare, mostly occurring secondary to pulmonary disease but nevertheless represent significant diagnostic challenges. Nasopharyngeal tuberculosis is rare, representing around 1% of all upper air-way localizations and the most common presentation is in the form of adenoids. Tuberculous glossitis (oral tuberculosis) is even scarcer and may present in various clinical forms, usually mimicking a malignant neoplasm, or, less often, trauma or other infectious lesions. Oropharynx tuberculosis is usually misdiagnosed as hypertrophic chronic tonsillitis. We present four rare cases of ENT tuberculosis, primary adenoiditis and tonsillitis in a 13-year-old girl, a curious case of tuberculous glossitis in a 65-year-old woman, clinically diagnosed as a lingual neoplasm and two cases of tuberculous lymphadenopathy uncommonly located in the submandibular and supraclavicular regions. A comprehensive review of literature follows the case presentations. Tuberculous manifestation in the ear, nose and throat area remains a difficult diagnosis to establish, particularly because of its rarity and non-specific clinical appearance, and should be included in the differential diagnosis of pharynx lesions. An early diagnosis is essential to avoid occurrence of complications.
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Affiliation(s)
| | - Horia Mocanu
- Department of ENT & HNS, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, Romania
| | - Cosmin Moldovan
- Faculty of Medicine, “Titu Maiorescu” University of Bucharest, Bucharest, Romania
- General Surgery Ward, ‘Witting’ Clinical Hospital, Bucharest, Romania
| | - Ioana Soare
- Faculty of Medicine, “Titu Maiorescu” University of Bucharest, Bucharest, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR (Centrul Integrat Multidisciplinar de Cercetare de Interfata Dermatologica - CIM-CID), “Dunărea de Jos” University, Galați, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Claudiu Ionut Vasile
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
| | - Daniela Diculencu
- Medical Analysis Laboratory, Clinical Pneumoftisiology Hospital, Iasi, Romania
| | - Paraschiva A Postolache
- Clinical Medical Department, Faculty of Medicine, “Grigore T Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, Galati, Romania
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4
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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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5
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Deshpande A, Gupta P, Simha Reddy AV, Ramachandra Reddy GV. Atypical presentation of tuberculosis. J Oral Maxillofac Pathol 2020; 24:404. [PMID: 33456266 PMCID: PMC7802856 DOI: 10.4103/jomfp.jomfp_56_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/03/2020] [Indexed: 11/10/2022] Open
Abstract
Developing countries such as India face an intense situation with communicable diseases such as tuberculosis (TB). It is an inflammatory infectious granulomatous disease commonly affecting the lungs. Extrapulmonary TB presentations have been documented, with the orofacial region also being involved. TB usually presents as an ulcer in the oral cavity with tongue and lip being the favored sites. TB presenting as a lip swelling is unusual even if it is a secondary lesion with a primary pulmonary involvement. We present a lip swelling and discuss the differential diagnosis. Investigation of ultrasonography revealed a vascular lesion which was disproved, suggesting an increase in vascularity even in diseases such as TB. We present a case of a lip swelling which led to the diagnosis of recurrent pulmonary TB which the patient was unaware of. Findings of histopathology revealing the absence of bacilli are also discussed. Monetary constraints frequently cause a neglect of dangerous diseases such as TB.
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Affiliation(s)
- Ashwini Deshpande
- Department of Oral Medicine and Radiology, GSL Dental College and Hospital, Rajahmundry, India
| | - Prashant Gupta
- Department of Oral Medicine and Radiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - A Vikram Simha Reddy
- Department of Oral and Maxillofacial Pathology, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - G V Ramachandra Reddy
- Department of Oral Medicine and Radiology, People's Dental Academy, Bhopal, Madhya Pradesh, India
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6
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Hamid R, Sharma P, Sheikh RA, Bhat M. Primary oral tuberculosis: A case series of a rare disease. J Oral Maxillofac Pathol 2020; 24:332-338. [PMID: 33456244 PMCID: PMC7802837 DOI: 10.4103/jomfp.jomfp_174_19] [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: 06/01/2019] [Revised: 03/04/2020] [Accepted: 03/23/2020] [Indexed: 11/04/2022] Open
Abstract
Tuberculosis (TB) is still one of the most life-threatening infectious diseases, resulting in high mortality in adults and is commonly found in developing countries. Lung is primarily affected while extrapulmonary TB is rarely encountered. Oral lesions, although rare, can be seen in both primary and secondary stages of TB. Primary oral TB may present a diagnostic challenge as its clinical features can be nonspecific that mimics other diseases and is usually misdiagnosed. Thus, it is very important to be aware and be highly suspicious of oral TB especially in endemic area. We share 4 such cases of primary oral TB with uncommon presentations (two on the gingiva, one on the palate and one on the tongue) The diagnosis was made by histopathological examination, polymerase chain reaction analysis and Mantoux test. They were successfully treated with antituberculous treatment. In secondary TB, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes or in any other part of the body and can be detected by a systemic examination.
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Affiliation(s)
- Rizwan Hamid
- Department of Oral Medicine and Radiology, GDC, Srinagar, Jammu and Kashmir, India
| | - Prenika Sharma
- Department of Oral Medicine and Radiology, GDC, Srinagar, Jammu and Kashmir, India
| | - Rayees Ahmad Sheikh
- Department of Oral Medicine and Radiology, GDC, Srinagar, Jammu and Kashmir, India
| | - Muzafar Bhat
- Department of Periodontics, GDC, Srinagar, Jammu and Kashmir, India
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7
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Lee ST, Jang SB, Kwon TG, Choi SY. Oral tuberculosis mimicking a traumatic denture ulcer. J Prosthet Dent 2019; 121:225-228. [DOI: 10.1016/j.prosdent.2018.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/13/2018] [Accepted: 04/14/2018] [Indexed: 12/12/2022]
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8
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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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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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10
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Extensive Inflammatory Gingival Tumor in a Young Nonsmoking Woman. J Craniofac Surg 2015; 26:e388-90. [DOI: 10.1097/scs.0000000000001865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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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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Verma SK, Upadhyay R, Chand P, Tayal N. Tuberculosis: oral alveolus and pulmonary alveoli coexisting. BMJ Case Rep 2014; 2014:bcr-2013-202014. [PMID: 25477361 DOI: 10.1136/bcr-2013-202014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
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.
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Affiliation(s)
- Sanjeev Kumar Verma
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rashmi Upadhyay
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Pooran Chand
- Department of Prosthodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Nitesh Tayal
- King George's Medical University, Lucknow, Uttar Pradesh, India
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13
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Bai S, Sun CF. Tuberculous Osteomyelitis of the Mandible With Diffuse Swelling of the Floor of the Mouth: A Case Report. J Oral Maxillofac Surg 2014; 72:749.e1-6. [DOI: 10.1016/j.joms.2013.11.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 11/26/2013] [Accepted: 11/28/2013] [Indexed: 11/29/2022]
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14
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Tuberculoma of the tongue presenting as hemimacroglossia. Case Rep Med 2012; 2012:548350. [PMID: 23319955 PMCID: PMC3538444 DOI: 10.1155/2012/548350] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 12/07/2012] [Accepted: 12/09/2012] [Indexed: 12/05/2022] Open
Abstract
The underdiagnosis of extrapulmonary tuberculosis lesions, along with an emerging global resistance to antitubercular drugs, warrants an increased awareness of the involvement of Mycobacterium tuberculosis in atypical lesions of oral cavity. Tongue is the most common site of oral tuberculosis. We report a rare presentation of lingual tuberculosis in a 65-year-old male, a chronic tobacco chewer, who came to us with swelling of the tongue which apparently looked like hemimacroglossia, leading to the clinical diagnosis of submucosal carcinoma of tongue. Enlargement of tongue is a slow process resulting from gradual invasion and lodging of bacilli in the tongue. Biopsy and histopathological examination revealed tuberculous etiology of the lesion and the patient responded well to antitubercular therapy.
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15
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Andrade NN, Mhatre TS. Orofacial Tuberculosis—A 16-Year Experience With 46 Cases. J Oral Maxillofac Surg 2012; 70:e12-22. [DOI: 10.1016/j.joms.2011.07.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 07/14/2011] [Accepted: 07/14/2011] [Indexed: 11/29/2022]
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16
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Al-Rikabi AC, Arafah MAR. Tuberculosis of the tongue clinically masquerading as a neoplasm: a case report and literature review. Oman Med J 2011; 26:267-8. [PMID: 22043432 DOI: 10.5001/omj.2011.64] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/07/2011] [Indexed: 11/03/2022] Open
Abstract
Tuberculosis of the tongue is a very rare event even in areas and countries in which tuberculosis is endemic. The disease can present itself in a variety of clinical appearances, most of which may mimic malignant lingual neoplasms clinically. In this case, we present a patient who initially complained of an ulcerated lingual swelling, which was suspected to be a squamous cell carcinoma on clinical examination. In addition, the diagnosis was missed on the first and initial biopsy as it was not representative of the lesion. The diagnosis of lingual tuberculosis was made by histopathology on a second biopsy. In this article, we described the clinicopathological features of tuberculous glossitis with a comparison between our case and other similar reported cases in addition to a literature review.
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17
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Ram H, Kumar S, Mehrotra S, Mohommad S. Tubercular ulcer: mimicking squamous cell carcinoma of buccal mucosa. J Maxillofac Oral Surg 2011; 11:105-8. [PMID: 23449034 DOI: 10.1007/s12663-011-0282-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 08/22/2011] [Indexed: 11/27/2022] Open
Abstract
Tuberculosis is a chronic granulomatous disease that rarely affects oral cavity. Tuberculous lesions of the oral cavity are frequently overlooked in the differential diagnosis of oral lesions. The oral clinical presentation of tuberculosis may take many forms as ulcers, nodules, tubercular fissure, tubercular papilloma and tuberculomas. Diagnosis is confirmed by histopathology.
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Affiliation(s)
- Hari Ram
- Department of Oral and Maxillofacial Surgery, CSM Medical University (Erstwhile King George's Medical University), Lucknow, India
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18
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Tuberculosis presenting as bilateral vocal fold palsy: case report and review of otolaryngological manifestations of tuberculosis. The Journal of Laryngology & Otology 2011; 125:1079-82. [PMID: 21810295 DOI: 10.1017/s002221511100185x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We report a rare case of tuberculosis presenting with bilateral vocal fold palsy. METHOD Case report and discussion of ENT manifestations of tuberculosis. CASE REPORT A 39-year-old man presented with stridor and bilateral vocal fold palsies, and underwent an emergency tracheostomy. Intra-operatively, a mass was identified overlying the thyroid cartilage. Fine needle aspiration cytology of this mass showed well formed granulomas but negative Ziehl-Nielsen staining. Computed tomography showed the mass to be surrounding the thyroid cartilage, causing airway occlusion; pulmonary infiltrates were also seen. The patient was commenced on tuberculosis treatment. Subsequent sputum samples from the tracheostomy confirmed the diagnosis. The patient responded very well to treatment, and was successfully decannulated after one week. CONCLUSION The incidence of tuberculosis in the UK is increasing, particularly in urban areas. The otolaryngologist may encounter a wide variety of presentations. Diagnosis requires a high index of clinical suspicion.
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19
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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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20
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Nagalakshmi V, Nagabhushana D, Aara A. Primary tuberculous lymphadenitis: A case report. Clin Cosmet Investig Dent 2010; 2:21-5. [PMID: 23662079 PMCID: PMC3645454 DOI: 10.2147/ccide.s9733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Tuberculosis (TB) is a prevalent systemic bacterial infectious disease usually caused by Mycobacterium tuberculosis. It is estimated that approximately 8 million people develop TB each year, and 3 million people die of complications associated with the disease. In this article we report a case of a 17-year-old female patient with a painful swelling in her right submandibular region. She was diagnosed with right submandibular tuberculous lymphadenitis. Tuberculous lymphadenitis, when occurring in the cervical region, continues to be a common cause of extrapulmonary TB. TB is a recognized occupational risk for dentists, as they work in close proximity to the nasal and oral cavities of patients, with the possible generation of potentially infectious sprays during routine operative procedures.
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Affiliation(s)
- Velpula Nagalakshmi
- Department of Oral Medicine and radiology, Sri Sai College of Dental Surgery, Kothrepally, Vikarabad, Andhra Pradesh, India
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21
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Herrero-González JE, Parera E, Viñas L, Pujol RM. An old woman with painful oral intake. J Eur Acad Dermatol Venereol 2009; 23:964-5. [DOI: 10.1111/j.1468-3083.2008.03072.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Tovaru S, Costache M, Sardella A. Primary oral tuberculosis: a case series from Bucharest, Romania. ACTA ACUST UNITED AC 2008; 105:e41-5. [DOI: 10.1016/j.tripleo.2008.01.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Revised: 01/23/2008] [Accepted: 01/23/2008] [Indexed: 11/28/2022]
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23
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Karbach J, Thal SC, Weber A, Springer E, Eich A, Genitsariotis R, Al-Nawas B. Swelling of the Buccal Cheek: An Unusual Presentation of Primary Tuberculosis. J Oral Maxillofac Surg 2007; 65:2108-11. [PMID: 17884549 DOI: 10.1016/j.joms.2007.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 02/05/2007] [Accepted: 05/08/2007] [Indexed: 10/22/2022]
Affiliation(s)
- Julia Karbach
- Department of Oral Surgery, Johannes Gutenberg University, Mainz, Germany.
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Vidal M, Delevaux I, André M, Marroun I, Gavet F, Voinchet H, Palat S, Kintossou R, Gilain L, Aumaître O. Tuberculose disséminée révélée par une localisation linguale. Rev Med Interne 2007; 28:124-6. [PMID: 17157966 DOI: 10.1016/j.revmed.2006.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 11/07/2006] [Accepted: 11/08/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Tuberculous lesions of the oral cavity are uncommon. Most of cases are secondary to pulmonary disease and the primary form is rare. EXEGESIS We report the case of a 64 year-old man, smoker, presenting a chronic ulcer of the tongue, with anorexia and important weight loss. The biopsy of this ulcer showed granulomatous inflammation and Langhans type giant cells, without necrosis. Ziehl-Nielsen stain was negative. Pulmonary lesions were subsequently detected (chest X-ray, CT-scan) and the disseminated tuberculosis was confirmed by a positive culture with acid-fast bacilli in urine, blood, and pulmonary sample. Antituberculosis treatment resulted in the complete resolution of the oral lesion. CONCLUSION Biopsy for histopathological diagnosis, acid-fast stains and culture, is essential to determine the exact nature of chronic oral ulceration to distinguish between oral malignancy, infectious (syphilis), traumatic, or aphthous ulcers. Tuberculosis of the tongue is a difficult diagnosis. However it should be searched for because treatment usually results in a rapid recovery.
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Affiliation(s)
- M Vidal
- Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, BP 69, 63003 Clermont-Ferrand cedex 01, France.
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Sareen D, Sethi A, Agarwal AK. Primary tuberculosis of the tongue: a rare nodular presentation. Br Dent J 2006; 200:321-2. [PMID: 16568055 DOI: 10.1038/sj.bdj.4813319] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2005] [Indexed: 11/09/2022]
Abstract
We report a case of a 38-year-old male who presented to us with a nodular swelling of the tongue with cervical lymphadenopathy suggestive of a malignancy. The lesion was diagnosed to be of tuberculous origin and the patient responded well to anti-tubercular chemotherapy.
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Affiliation(s)
- D Sareen
- Department of ENT & Head and Neck Surgery, Maulana Azad Medical College and associated L. N. Hospital, New Delhi 110002, India
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Heigis G, Krimmel M, Hoffmann J, Kaiserling E, Reinert S. Orale Manifestation einer miliaren Tuberkulose. ACTA ACUST UNITED AC 2005; 9:180-3. [PMID: 15726436 DOI: 10.1007/s10006-005-0596-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
CASE REPORT We report on the clinical course of a 40-year-old patient with an oral manifestation of miliary tuberculosis. In addition to oral mucosa and lung, the colon and ileum were also infested. The oral lesions may resemble malignant tumors and are difficult to diagnose, especially because tuberculosis has become a rare disease in industrialized countries. DISCUSSION Oral lesions and concomitant pulmonary complaints can be a sign for existing tuberculosis. Patients with these problems should undergo a chest X-ray and a biopsy from the oral mucosa. In addition, tests should be conducted to determine if mycobacteria are present in the sputum, gastric fluid, and urine and cultures grown. In cases with negative results PCR may detect DNA of Mycobacterium tuberculosis.
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Affiliation(s)
- G Heigis
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Tübingen
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Abstract
Oral ulceration is a common problem, and is sometimes a marker of gastroenterological disease. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease. Indeed, a spectrum of disorders other than those of the gut can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. This present article reviews aspects of the aetiology, diagnosis and management of common ulcerative disorders of the oral mucosa.
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Affiliation(s)
- S R Porter
- Oral Medicine, Division of Maxillofacial Diagnostic, Medical and Surgical Sciences, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, London, UK.
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28
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Abstract
Tuberculosis is one of the major causes of ill health and death worldwide. Nevertheless, tuberculous lesions of the oral cavity are rare and can be a diagnostic challenge, particularly in young immunocompetent patients. Most of the cases are secondary to pulmonary disease and the primary form is uncommon. In this paper, we present a case of primary oral tuberculosis, affecting the floor of mouth in a 13-year-old Brazilian male patient.
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Affiliation(s)
- F A Ito
- Semiology and Oral Pathology, Dental School, University of Campinas, Piracicaba, SP, Brazil
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