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Clinical Note |

Primary Tuberculosis of the Oral Cavity in an Elderly Nonimmunosuppressed Patient Case Report and Review of the Literature

Wenko Smolka, MD, DMD, FEBOMFS; Hana Burger, MD; Tateyuki Iizuka, MD, DDS, PhD, FEBOMFS; Koord Smolka, MD, DMD, FEBOMFS
Arch Otolaryngol Head Neck Surg. 2008;134(10):1107-1109. doi:10.1001/archotol.134.10.1107.
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Tuberculosis (TB) is a chronic infectious granulomatous disease that is caused in human beings by Mycobacterium tuberculosis and, less frequently, by Mycobacterium bovis. Atypical mycobacteria have also been recognized.1 Tuberculosis has been a worldwide health problem for centuries. Although the prevalence of TB was reduced decades ago, the number of cases started increasing again because of the epidemic of human immunodeficiency virus infection and the development of multidrug-resistant species of the bacteria.2 Patients who are immunocompromised have a much higher incidence of oral lesions. These lesions are commonly caused by atypical forms of bacteria such as Mycobacterium avium-intracellulare.3

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Figure 1.

Clinical view showing an ulcer covered by a grayish white slough on the alveolar ridge of the right mandible.

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Figure 2.

Histologic section showing a caseating granuloma composed of Langerhans giant cells and lymphocytes (A) as well as acid-fast Mycobacterium tuberculosis, a straight, rod-shaped bacillus (B) (hematoxylin-eosin, original magnification ×20 [A]; Ziehl-Neelsen, original magnification ×100 [B]).

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Figure 3.

Polymerase chain reaction analysis was performed using polyacrylamide gel electrophoresis. IS indicates insertion sequence; M, Mycobacterium; h, size marker; and bp, base pair.

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