Oral manifestation of tuberculosis: a case-report

Abstract

The present case-report describes tuberculosis on the oral mucosa, in a rare manifestation of the disease. The importance of appropriate diagnosis and awareness of the clinical manifestations is highlighted. Oral lesions seem to occur as chronic ulcers, nodular or granular areas, and rare, firm leukoplakia regions. Most extra-pulmonary lesions represent secondary infections of a primary lung infectious focus; therefore, early and accurate diagnosis is required for planning of the best treatment and strategies to control the disease.

Keywords: Mycobacterium infection; Mycobacterium tuberculosis; Oral lesion; Oral tuberculosis.

Fig. 1

Clinical aspects of oral TB lesions and lung radiographic findings. Ulcerative lesions with granulomatous center and whitish halo on the upper labial mucosa near the median line (A) and on the left jugal mucosa, near the labial posterior commissure (B). Full radiograph of the lower left pulmonary lobe. Presence of active disease manifested as budding tree-like centrilobular nodules in both lungs, especially on the right (C).

Fig. 2

Histopathological analysis of a sample collected from oral TB lesions. Granulomas surrounded by intense mixed inflammatory infiltrate, with inflammatory cells inside the epithelium. Hematoxylin–eosin staining, 100× magnification (A). Well-shaped granulomas surrounded by epithelioid histiocytes and inflammatory cells. Arrows indicate incipient necrosis. Hematoxylin–eosin staining, 200× magnification (B). Arrow indicates giant Langhans cell, with nuclei distributed across the peripheral cytoplasm, in a necklace pattern. Langhans cells are typical of TB. Ziehl–Neelsen staining, 600× magnification (C).