Review paper Tuberculosis of the oral cavity: an uncommon but still a live issue

Abstract

This paper aims at characterizing clinical features, occurrence, diagnostic process and treatment of oral tuberculosis (TB), basing on the available literature. Oral TB manifestations are uncommon and usually secondary to pulmonary changes. They predominantly appear as ulcers. Eruptions are usually single, painful and resistant to conventional treatment. Diagnosis always needs to be confirmed histopathologically. Anti-tubercular systemic therapy is required in every patient diagnosed with oral TB, while topical treatment is only adjuvant. A low incidence of oral TB together with a non-specific clinical picture might pose difficulties in its diagnosis. Oral changes in TB are likely to be overlooked what can result in further spread of Mycobacterium tuberculosis due to a delay in instituting proper treatment. Tuberculosis morbidity has risen recently and more multi-drug resistant strains of TB bacilli are found, what can result in a higher incidence of oral TB. Clinicians should be therefore aware of a possible occurrence of this entity and consider it while making a differential diagnosis of atypical oral changes.

Tuberculosis of Tongue: A Case Report

“…3 Tuberculosis of oral cavity has an incidence of 0.5-1.5%. 4 Very low incidence may be due to saliva cleaning the oral mucosa continuously and also the resistance offered by the oral mucosal epithelium lining. Risk factors mainly include mucosal trauma, smoking and poor hygiene.…”

Oral Tuberculosis: A Rare Manifestation of Disseminated Disease in a Patient with Dermatomyositis on Chronic Corticosteroids

“…There are many documented cases of extra pulmonary tuberculosis; however, infection of the oral cavity is exceedingly rare [3, 4]. The oral cavity is an unlikely site for M. tuberculosis inoculation due to the inhibitory properties of saliva on mycobacteria [5].…”

“…Odynophagia, dysphonia, halitosis, and excessive salivation are other common symptoms of oral tuberculosis [3, 4]. Systemic symptoms of weight loss, anorexia, fever and night sweats may also be present.…”

“…Tuberculosis of the oral cavity poses a diagnostic challenge due to its rarity and ability to mimic the appearance of many different conditions such as malignancy, granulomatosis with polyangiitis (formerly Wegener's), actinomycosis, mycotic infections, syphilis, sarcoidosis, Crohn's disease, tongue mycoses, and cat scratch disease [3, 4]. The diagnosis relies on the combination of tissue histology, microbial staining, and culture or polymerase chain reaction.…”

“…Tuberculosis of the oral cavity is an exceedingly rare manifestation of disease with an incidence of 0.5–1.5% [3]. We report a case of a Haitian born patient with dermatomyositis on chronic steroid therapy, presenting with lingual disease as the only symptom of disseminated tuberculosis.…”