Oral ulcer: an uncommon site in primary tuberculosis

Area of Science:

• Infectious Diseases
• Oral Medicine
• Dermatology

Background:

• Tuberculosis (TB) is a significant global health concern, causing widespread morbidity and mortality.
• While TB primarily affects the lungs, it can present with oral manifestations.
• Oral tuberculosis lesions are uncommon but can occur in various stages of the disease.

Observation:

• A rare case of primary tuberculosis presenting as a persistent, tender ulcer on the lingual mucosa of the mandibular arch is detailed.
• The lesion's location in the molar zone of an edentulous arch was atypical.
• Diagnostic confirmation involved histopathology, polymerase chain reaction (PCR), purified protein derivative (PPD) testing, and chest radiography.

Findings:

• The patient received a six-month treatment regimen comprising four anti-tuberculotic antibiotics.
• Clinical resolution of the oral ulcer was observed within three months of initiating therapy.
• This case highlights the importance of considering tuberculosis in the differential diagnosis of non-healing oral ulcers.

Implications:

• The resurgence of tuberculosis necessitates heightened clinical awareness.
• Clinicians should consider oral tuberculosis in the differential diagnosis of persistent, non-healing oral ulcers.
• Prompt diagnosis and appropriate anti-tuberculotic therapy can lead to successful outcomes for oral TB manifestations.