Kakisi Ourania K, Kechagia Argiro S, Kakisis Ioannis K, Rafailidis Petros I, Falagas Matthew E
Alfa Institute of Biomedical Sciences, Athens, Greece.
Eur J Oral Sci. 2010 Apr;118(2):103-9. doi: 10.1111/j.1600-0722.2010.00725.x.
The recent increase in the incidence of tuberculosis, combined with an emerging global resistance to antituberculous drugs, warrants an increased awareness of the involvement of Mycobacterium tuberculosis in persistent or atypical lesions in the oral cavity. We sought to review the published reports of mycobacterial infection of the oral cavity found in the literature in otherwise uncompromised patients, from 1950 to the present day, and analyzed the documented manifestations. M. tuberculosis infects all parts of the mouth (soft and hard palate, uvula, buccal mucosa, gingivae, lips, tongue, maxilla, and mandible) more often in men than in women, appearing predominantly in the form of ulcerative lesions. It was found as a secondary infection in 58% (54% pulmonary, 4% extrapulmonary) of patients and as a primary infection in 42% of patients. Carcinomas are found to co-exist in the same lesion site in 3% of patients. In approximately 50% of patients, an oral manifestation of TB has led to the diagnosis of a previously unknown systemic infection, which resulted in a timely and effective treatment. The investigation for tuberculosis should therefore be actively pursued in the dental surgery. Diagnostic work-up for systemic involvement and control of healthcare-associated spread is important, while therapeutic options are still considered adequate.
近期结核病发病率上升，加上全球出现对抗结核药物的耐药性，这就需要提高对结核分枝杆菌累及口腔持续性或非典型性病变的认识。我们试图回顾1950年至今文献中报道的在其他方面健康的患者口腔分枝杆菌感染情况，并分析记录的临床表现。结核分枝杆菌感染口腔的所有部位（软腭、硬腭、悬雍垂、颊黏膜、牙龈、嘴唇、舌头、上颌骨和下颌骨），男性比女性更常见，主要表现为溃疡性病变。在58%的患者中为继发感染（54%为肺部感染，4%为肺外感染），42%的患者为原发感染。3%的患者在同一病变部位同时存在癌。约50%的患者中，口腔结核表现导致诊断出先前未知的全身感染，从而实现了及时有效的治疗。因此，在牙科手术中应积极开展结核病调查。对全身受累情况进行诊断检查并控制医疗相关传播很重要，同时治疗选择仍被认为是充分的。
