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Oral ulcer as presentation of cavitating pulmonary tuberculosis

Authors
  • Fragoso, Joana1
  • Oliveira, Mariana Marques2
  • Gonçalves, Celina1, 3
  • Méndez, Josefina1
  • Sarmento-Castro, Rui1
  • 1 Serviço de Doenças Infeciosas do Centro Hospitalar Universitário do Porto, Portugal
  • 2 Serviço de Anatomia Patológica do Centro Hospitalar Universitário do Porto, Portugal
  • 3 Serviço de Cuidados Intensivos do Centro Hospitalar Universitário do Porto, Portugal
Type
Published Article
Journal
IDCases
Publisher
Elsevier
Publication Date
Oct 01, 2020
Volume
22
Identifiers
DOI: 10.1016/j.idcr.2020.e00976
PMID: 33083228
PMCID: PMC7554358
Source
PubMed Central
Keywords
License
Unknown

Abstract

Tuberculosis is an indolent infection that can invade any organ. Although the most frequent form of presentation is pulmonary, it can have an extra-pulmonary presentation, including rare cases of oral tuberculosis. We present a clinical case of a 44 year-old man, active smoker, with an ulcerated lesion on the posterior third of the tongue, initially interpreted as a probable neoplasm. The pathological study of the biopsy performed on the lesion, showed alterations compatible with a chronic granulomatous process and the presence of acid-fast bacilli. The concomitant diagnosis of pulmonary tuberculosis was made in a subsequent study. The patient started therapy with isoniazid, rifampin, pyrazinamide and ethambutol with complete resolution of the oral lesion and pulmonary tuberculosis. This case exemplifies the importance of including tuberculosis in the differential diagnosis of ulcerated and neoformative lesions and the value of performing a microbiological study alongside the pathological one.

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