Primary tooth abscess caused by Mycobacterium bovis in an immunocompetent child

Abstract

Bovine tuberculosis is a zoonotic disease, and although its incidence has dramatically decreased in developed countries where effective control measures are applied, it still remains a potential health hazard in the developing world. Tuberculosis of the oral cavity is extremely rare and is usually secondary to pulmonary involvement. We present the unusual case of an immunocompetent 6-year-old child residing in an urban area with primary oral tuberculosis due to Mycobacterium bovis, which was confirmed by the application of a molecular genetic approach. M. bovis belongs to Mycobacterium tuberculosis complex which comprises species with close genetic relationship, and for this reason, the use of new molecular techniques is a useful tool for the differentiation at species level of the closely related members of this complex.

Oral ulcer: an uncommon site in primary tuberculosis

“…Tuberculosis is a major cause of morbidity and mortality worldwide. The risk of infection is much greater among people in lower socio‐economic groups, rural dwellers or people with occupational exposure . The primary form of TB is most often localized to the lungs .…”

“…Tuberculosis is usually caused by Mycobacterium tuberculosis , by direct person‐to‐person spread through airborne droplets and, less frequently, by ingestion of unpasteurized cow milk infected by Mycobacterium bovis or by other atypical Mycobacteria …”

“…Depending on the infected site, tuberculosis is classified clinically as pulmonary and extrapulmonary. Pulmonary tuberculosis remains the most common form of the disease but other sites may be involved, including the lymphatic, skeletal and central nervous systems, the skin, kidneys, pharynx and gastrointestinal tract . Extrapulmonary involvement in tuberculosis is uncommon, accounting for approximately 10% to 15% of all infected people .…”

“…Extrapulmonary involvement in tuberculosis is uncommon, accounting for approximately 10% to 15% of all infected people . The global prevalence of human TB due to Mycobacterium bovis has been estimated at 3.1% of all human TB cases …”

“…Most cases appear as a chronic painless ulcer . Primary oral tuberculosis without pulmonary involvement is extremely rare since most oral lesions represent a secondary infection from initial pulmonary lesions …”