A case of mandibular tuberculosis osteomyelitis with no pulmonary lesion

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Abstract

Pulmonary tuberculosis (TB) is recognized as an infectious disease, usually transmitted by infectious air droplets. It has a rare oral manifestation, which may occur as a secondary lesion in gingival tissue, palate, tongue, and jaw bones. However, bony TB may occur as a single lesion without systemic manifestations in the form of chronic osteomyelitis, with areas of increased resistance to antibiotics. The case presented is a female patient who was referred to the Oral and Maxillofacial Surgery Department with a previous diagnosis of TB lymphadenitis. She presented with an on and off suppurative swelling related to the lower right molar area following extraction of a lower molar 8 months ago. Aspiration biopsy showed negative acid-fast bacilli and TB culture, whereas computed tomography provided a picture of chronic osteomyelitis. The anti-TB regimen was continued and the patient was observed weekly. The acute symptoms subsided within a week and the swelling regressed gradually to the normal size. The lesion was possibly considered a TB mandibular osteomyelitis. Thus, with the increase in disease prevalence, especially in developing countries, the chances of patients reporting first to the dental office should not be overlooked.

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