Oral ulcer: an uncommon site in primary tuberculosis

Abstract

Tuberculosis is a chronic infectious disease and a major cause of morbidity and mortality worldwide. It can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, have been observed in both primary and secondary stages of the disease. This article presents a case of primary tuberculosis manifested as a nonhealing, tender ulcer on the lingual mucosa of the edentulous right mandibular arch molar zone, an uncommon site. The diagnosis was confirmed after histopathology examination, polymerase chain reaction and purified protein derivative tests and chest radiograph. A recommended treatment plan of six months with four anti-tuberculotic antibiotics was commenced. Clinically, the oral ulcer disappeared three months after the commencement of treatment. The resurgence of tuberculosis should compel clinicians to include the disease in the differential diagnosis of various types of non-healing oral ulcers.

An Unusual Granular Ulcer Secondary Oral Tuberculosis of Vestibule Mandibular Mucosa

“…A good follow-up of the regimen of adequate antituberculous treatment could prevent the oral TB. In this regard, we agree with what was reported by Pavlinac et al, 1 Araj et al, 2 Taute et al, 3 Trinh et al, 4 Nagaraj et al, 5 and Aoun et al 12 However, when the lesion is established, it is necessary to consider the diagnosis of oral TB to determine the appropriate treatment for each patient. In relation to the surgical treatment of granular ulcer secondary oral TB, the bibliographic evidence is scarce.…”

“…[6][7][8][9][10][11] According to published research by various authors two types of oral TB are recognized: primary oral TB which is more common in young patients and causes enlarged lymph nodes and secondary oral TB which is registered in adults of middle and advanced age with M. tuberculosis infecting buccal mucosa, gingival mucosa, tongue, lingual frenulum, and lips. [12][13][14] We reported a routine examination in the oral cavity of a 42-year-old female patient, in whom a granular ulcer that does not heal was observed, chronic, of irregular appearance, with a deep depression of 2 cm in diameter, located in vestibular mucosa of the premolar area of the left mandibular arch was present. This finding of secondary TB according to the clinical manifestation did not present enlarged or painful local lymph nodes identifying an irregular surface ulcer covered with Trelat granules.…”

Exophytic Solitary Ulcerated Chronic Lesion of the Mouth; What Diagnosis and Treatment

“…[14] Tubercolosis is a chronic infection disease, it can affect any part of body including the oral cavity, where it can manifest as a non healding, tender ulcer on the oral mucosa. [15] Syphilis is a sexual transmitted infection transmitted by Treponema Pallidum, Primary syphilic chancre most often involved genitalia , also extragenital lesions are reported. In the oral cavity the Syphilic lesion appears as erythematous indurated nodule with ulcer.…”

Oral manifestations of systemic disease

“…Metastatic disease generally does not give rise to ulcers of the mouth, although as noted above can manifest within the mandible as a swelling and/ or paraesthesia/anaesthesia. 14 Other rare causes of solitary ulceration of possible systemic origin include syphilis (eg tertiary disease), primary or secondary infection of Mycobacteria tuberculosis or mycobacteria other than tuberculosis (MOTT) 15,16 and systemic mycoses (eg mucormycosis, aspergillosis, histoplasmosis and paracoccidiodomycosis). 17 Solitary ulceration secondary to neutropenias are also possible, although extensive ulceration might be more likely than single ulcers.…”