A disguised tuberculosis in oral buccal mucosa

Abstract

Tuberculosis is a major cause of morbidity and mortality worldwide. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This article presents a case of tuberculosis of the buccal mucosa, manifesting as non-healing, non-painful ulcer. The diagnosis was confirmed based on histopathology, sputum examination and immunological investigation. The patient underwent anti-tuberculosis therapy and her oral and systemic conditions improved rapidly. Although oral manifestations of tuberculosis are rare, clinicians should include them in the differential diagnosis of various types of oral ulcers. An early diagnosis with prompt treatment can prevent complications and potential contaminations.

Keywords: Buccal mucosa; Oral lesion; Tuberculosis.

Figure 1

(A) Extraoral photograph shows enlarged cervical lymph node, (B) Intra orally photograph shows an ulcer with well defined margins on the right buccal mucosa covered by a yellow pseudomembrane, (C) Histopathological slide shows granulomatous inflammation with Langhans giant cells and focal caseous necrosis (hematoxylin and eosin stain), (D) Langhans cells containing nuclei arranged in a horseshoe shaped pattern at cell periphery (arrow), (E) Several acidfast bacilli in the sputum (Ziehl-Neelsen stain).