RESUMEN
Introduction: Oral tuberculosis is a chronic granulomatous disease caused by Mycobacterium tuberculosis. According to the World Health Organization (WHO), nearly 2 billion people are infected with tuberculosis. Objective: To report a rare case of oral tuberculosis with ulcers at two different sites. Materials and methods: In order to emphasize the need to consider tuberculosis in the differential diagnosis of non-healing ulcers of oral cavity and the role of oral physician in preventing the spread of such lesions, this article presents a case of oral ulcers at two different sites, diagnosed as tuberculosis ulcer. Results: Oral cavity, which is considered to be a mirror of systemic health, rarely manifests tuberculosis. With increasing number of tuberculosis cases and unusual form of the disease in the oral cavity, the cases are likely to be misdiagnosed. Conclusion: An oral clinician should have a thorough knowledge of tuberculosis and its oral manifestations.
Introdução: A tuberculose oral é uma doença granulomatosa crônica causada pelo Mycobacterium tuberculosis. Segundo a Organização Mundial da Saúde (OMS), cerca de 2 bilhões de pessoas estão infectadas com tuberculose. Objetivo: Relatar um caso raro de tuberculose oral com úlceras em dois locais diferentes. Materiais e métodos: Para realçar a necessidade de considerar a tuberculose sob o diagnóstico diferencial das úlceras não curadas da cavidade oral e o papel do dentista na prevenção da propagação de tais lesões, este artigo apresenta um caso de úlceras orais em dois locais diferentes, diagnosticados como úlcera de tuberculose. Resultados: A cavidade oral, considerada como um espelho da saúde sistêmica, raramente manifesta a tuberculose. Com um número cada vez maior de casos de tuberculose e a forma não usual da doença na cavidade oral, os casos são frequentemente diagnosticados erroneamente. Conclusão: O dentista clínico geral deve ter um conhecimento profundo da tuberculose e de suas manifestações orais.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Mucosa Bucal/patología , Tuberculosis Bucal/patología , Úlceras Bucales/patología , Biopsia , Tuberculosis Bucal/complicaciones , Úlceras Bucales/etiologíaAsunto(s)
Faringitis/etiología , Tuberculosis Laríngea/diagnóstico , Tuberculosis Miliar/diagnóstico , Tuberculosis Bucal/diagnóstico , Trastornos de Deglución/etiología , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium tuberculosis/aislamiento & purificación , Micosis/diagnóstico , Esputo/microbiología , Tuberculoma/diagnóstico , Tuberculoma/patología , Tuberculosis Laríngea/complicaciones , Tuberculosis Ganglionar/diagnóstico , Tuberculosis Bucal/complicaciones , Trastornos de la Voz/etiología , Pérdida de PesoRESUMEN
OBJECTIVE: Tuberculosis (TB) affecting the oral cavity is a very rare disease. We reviewed the medical data of 18 HIV(1)-infected patients referred to the Stomatology Group, Ear, Nose, and Throat Department, São Paulo University Medical School, who had a diagnosis of oral tuberculosis, between 1991 and 2002. This retrospective study aimed to analyze the relationship between oral tuberculosis and HIV infection. STUDY DESIGN: The clinical records of the patients were reviewed to note age and gender, symptoms, and site and type of the lesions in the oral mucosa. Results of CD4+ T-lymphocyte count, sputum analysis, tuberculin skin test, histopathologic characteristics, cultures of the specimens (that were taken during the biopsy), chest x-ray findings, and the type of treatment they received were also reviewed. RESULTS: The most affected sites were palate and tongue. All patients had culture confirming tuberculosis. CONCLUSION: Patients with HIV and nonhealing oral lesions or papillomatous masses in the oral mucosa should be screened for the presence of pulmonary tuberculosis.
Asunto(s)
Infecciones por VIH/complicaciones , Tuberculosis Bucal/complicaciones , Adulto , Anciano , Brasil , Femenino , VIH-1 , Humanos , Masculino , Persona de Mediana Edad , Mucosa Bucal/patología , Estudios RetrospectivosRESUMEN
The report describes an HIV/AIDS patient seen at a referral center in Mexico City, in whom a mycobacterial infection in the oral mucosa, probably tuberculosis (TB) was identified. The purpose is to describe the clinical and histological findings in an HIV-infected patient, who after being treated successfully for tuberculous lymphangitis 4 years ago, presented with a lingual ulcer as the only suggestive sign of recurrence of mycobacterial infection, probably M. tuberculosis. A 39-year-old man seen in the HIV clinic of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" in Mexico City since 1991 for HIV infection. In 1999 the patient developed tuberculous lymphangitis; he was managed with a 4-drug regimen for 12 months, with improvement of local and systemic symptoms. In May of 2003, the patient presented a painful superficial lingual ulcer, 0.7 cm in diameter, well circumscribed, crateriform with slightly elevated, irregular and indurated borders, of 4 months duration. The histopathological examination showed chronic granulomatous inflammation with giant multinucleated cells, suggestive of mycobacterial infection, and recurrence of TB was considered. Rifampin, isoniazide, pyrazinamide, ethambutol and streptomycin were administered. The lingual lesion improved with partial healing at the first week and total remission at 45 days after the beginning of the antituberculous treatment. In June, 2003, the patient began highly active antiretroviral therapy (HAART) that included two NRTIs and one NNRTI. At 7 months of follow-up, the patient remains free of lingual lesions. The particularity of the present case is that the lingual ulcer was the only sign of infection by mycobacteria, suggestive of TB, in an HIV/AIDS patient that probably represented a recurrence of a previous episode.
Asunto(s)
Infecciones por VIH/complicaciones , Úlceras Bucales/etiología , Enfermedades de la Lengua/patología , Tuberculosis Bucal/patología , Adulto , Terapia Antirretroviral Altamente Activa , Antituberculosos/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , México , Mucosa Bucal/patología , Mycobacterium tuberculosis/aislamiento & purificación , Úlceras Bucales/microbiología , Úlceras Bucales/patología , Recurrencia , Lengua/microbiología , Lengua/patología , Enfermedades de la Lengua/etiología , Enfermedades de la Lengua/microbiología , Tuberculosis Ganglionar/patología , Tuberculosis Bucal/complicaciones , Tuberculosis Bucal/tratamiento farmacológicoRESUMEN
We report an unusual case of a 58-year-old man with a "collision lesion" of the buccal space. Initially diagnosed as tuberculoma, the patient showed only partial response to an extensive course of antibiotics, prompting more vigorous investigation. This revealed the presence of a concomitant malignancy, specifically adenoid cystic carcinoma. Definitive treatment was then achieved by surgical resection and flap reconstruction with postoperative radiation therapy.
Asunto(s)
Carcinoma Adenoide Quístico/complicaciones , Mejilla/patología , Neoplasias de la Boca/complicaciones , Tuberculoma/complicaciones , Tuberculosis Bucal/complicaciones , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Neoplasias de la Boca/cirugía , Enfermedades de las Parótidas/complicaciones , Enfermedades de las Parótidas/patología , Radioterapia Adyuvante , Tuberculoma/tratamiento farmacológico , Tuberculoma/patología , Tuberculosis Bucal/tratamiento farmacológico , Tuberculosis Bucal/patologíaRESUMEN
We report the unusual simultaneous occurrence of lymphoepithelial cysts, cytomegalovirus (CMV) and mycobacterial infections in the intraparotid lymph nodes of a 52-year-old AIDS patient who died of disseminated mycobacteriosis. Although cytomegalovirosis is a common finding in the salivary glands of HIV patients, the association of CMV inclusions with lymphoepithelial cyst (LC) has not been previously reported. Parotid mycobacterial infection is an uncommon finding, despite its usual disseminated presentation in HIV patients. These data emphasize that in immunosuppressed patients, simultaneous diseases of the parotid gland may occur and should be considered for diagnosis and treatment.