Primary Tuberculosis of the Tongue: A Case Report

Abstract

The purpose of this article is to report a rare case of primary tuberculosis of the tongue. Background: Tuberculosis is an infectious, chronic granulomatous disease that can involve almost any organ in the body, but primary lesions are usually confined to the lungs. Oral lesions are an infrequent occurrence in tuberculosis, and tuberculosis of the oral cavity is often a consequence of active pulmonary tuberculosis. Although primary tuberculosis in the oral cavity has been documented, it is a rare occurrence. Report: A 42-year-old male patient presented with chief complaints of severe pain and ulceration on the ventrolateral surface of the left side of the tongue, measuring about 1.25×1.50 cm with surrounding erythema and induration of one-month duration. The ulcer was initially painless but became painful later with increased severity over time. The sore tongue caused difficulty in eating, drinking, swallowing, and even talking. The patient also complained of malaise for some duration, but there was no history of fever, cough, weight loss, and his bladder-bowel habits were normal. An excisional biopsy differentiated the lesion from squamous cell carcinoma and confirmed the diagnosis. Summary: Even though primary tuberculosis in the oral cavity is a rare finding, it must be included in the differential diagnosis of mucosal lesions. This case provides a clinical example of the importance of this inclusion for the well being of the patient and for the community due to the communicable nature of the disease.

Clinical Pathologic Conference Case 5: Agranulocytosis

“…In the oral cavity, a large, indurated ulcer is the usual presenting sign [1,4]. Increasingly, atypical and drug-resistant forms are seen, often associated with immunocompromised states, such as HIV/AIDS [1].…”

Primary Lingual Tuberculosis in Immunocompetent Patient: a Case Report

“…Histopathological evaluation reveals caseating epithelioid cell granulomas with Langhan's and/or foreign body giant cells. Most often complete remission of the tubercular ulcer of tongue takes place after standard antitubercular treatment using drugs like isoniazid, rifampicin, pyrazinamide, and ethambutol for a period of 6 months [7].…”

“…Any area of chronic irritation or inflammation may favour localization of mycobacterium associated with the disease. Secondary tuberculosis of the oral cavity may arise in a previously sensitised individual and is associated with pulmonary lesions [7].…”

Oral ulcers: clinical aspects. A tool for dermatologists. Part II. Chronic ulcers

“…Tuberculosis (TB) is a chronic granulomatous infectious disease, mainly caused by Mycobacterium tuberculosis , which has regained prevalence as a severe complication of human immunodeficiency virus (HIV) infection 21–24 . Oral lesions are rare, resulting from primary tuberculosis of the oral cavity, or secondary to active pulmonary tuberculosis.…”

“…Oral lesions are rare, resulting from primary tuberculosis of the oral cavity, or secondary to active pulmonary tuberculosis. In the former case, the disease presents as a deep, irregular, persistent and painful ulcer, commonly located on the side of the tongue, with a rolled border and granulation tissue in the fundus 21,22 . Secondary tuberculosis of the oral cavity presents as a chronic ulcer, generally painful and indurated 24 .…”