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Palate Tuberculosis with Paradoxical Lymphadenitis
Ines Kechaou1, Rym Abida1, Mohamed Salah Hamdi1
1Department B of Internal Medicine, Faculty of Medicine, Charles Nicolle Hospital, University of Tunis El Manar, Tunis, Tunisia.
Journal of Global Infectious Diseases
|July 1, 2021
Summary
Tuberculosis (TB) of the oral cavity is rare, but this case highlights a paradoxical reaction (PR) during treatment. Physicians should suspect TB in chronic oral lesions and consider PRs when lesions behave differently.
Area of Science:
- Infectious Diseases
- Oral Medicine
- Rheumatology
Background:
- Oral tuberculosis, especially palatine involvement, is exceptionally rare, typically managed with standard antitubercular therapy.
- Paradoxical reactions (PRs) can complicate tuberculosis treatment, posing diagnostic and management challenges for clinicians.
Observation:
- A 30-year-old female with juvenile idiopathic arthritis and systemic lupus erythematosus presented with bifocal tuberculosis affecting the palate and cervical lymph nodes.
- After two months of antitubercular therapy, the oral lesions showed favorable healing, while cervical lymph nodes exhibited a paradoxical reaction.
Findings:
- The case demonstrates a rare instance of oral TB with a subsequent PR in cervical lymph nodes despite effective treatment of oral lesions.
- This presentation underscores the complex and sometimes disparate responses to tuberculosis treatment.
Implications:
- Clinicians should consider tuberculosis in cases of chronic, drug-resistant oral erosions.
- Awareness of paradoxical reactions is crucial, especially when one TB lesion improves while another, like cervical lymphadenopathy, worsens during treatment.
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