Issa Sabah Abdulaziz, Abdulnabi Hussein Ali, Jameel Mustafa Emaduldeen
Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Medical City Complex, Bab Al Muadham, 10047, Baghdad, Iraq.
Oral and Maxillofacial Surgery Board Resident, Department of Oral and Maxillofacial Surgery, Medical City Complex, Bab Al Muadham, 10047, Baghdad, Iraq.
IDCases. 2020 May 15;21:e00825. doi: 10.1016/j.idcr.2020.e00825. eCollection 2020.
Tuberculosis is typically a pulmonary chronic infectious disease with a high prevalence in developing countries which carries a substantial rate of mortality. Extrapulmonary disease may occur, mainly second to the endogenous spread of the pathogen from the primary site. Oral or mandibular involvement represents a minority among the reported cases. A 12-year-old female patient with a diffuse left-sided facial swelling and dull pain that gradually developed over 8 months, presented to us with misdiagnosis and poor management. Examination was found to have a firm swelling involving the buccal region, and left posterior mandible with intact overlying skin and mucosa, and palpable cervical lymphadenopathy. Imaging showed a heterogeneous osteolytic lesion of left ramus extending to the surrounding soft tissue. The diagnosis with oro-facial tuberculosis was established by histopathological study and confirmed by the Mantoux test and polymerase chain reaction. Although it occurs rarely, oro-facial tuberculosis has detrimental local and systemic effects, and devoid of characteristic clinical and radiographic features, poses a diagnostic challenge.
结核病通常是一种肺部慢性传染病，在发展中国家发病率很高，死亡率也相当高。肺外疾病可能会发生，主要是由于病原体从原发部位内源性传播所致。口腔或下颌受累在报告的病例中占少数。一名12岁女性患者，左侧面部弥漫性肿胀并伴有钝痛，症状在8个月内逐渐发展，前来就诊时被误诊且治疗不佳。检查发现颊部区域及左下颌后部有质地坚硬的肿胀，表面皮肤和黏膜完整，可触及颈部淋巴结肿大。影像学检查显示左侧下颌支有不均匀的溶骨性病变，并延伸至周围软组织。通过组织病理学研究确诊为口腔面部结核，并经结核菌素试验和聚合酶链反应证实。尽管口腔面部结核很少见，但它会对局部和全身产生有害影响，且缺乏特征性的临床和影像学表现，给诊断带来挑战。
