Primary oral tuberculosis in an immunocompetent patient

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Jihene Chelli ◽  
◽  
Asma Ben Mabrouk ◽  
Houcem Elomma Mrabet ◽  
Mohamed Masmoudi ◽  
...  
Keyword(s):  
Granulomatous Inflammation ◽  
Immunocompetent Patient ◽  
Tuberculosis Treatment ◽  
Primary Tuberculosis ◽  
Caseous Necrosis ◽  
Cancerous Lesion ◽  
Painful Ulceration ◽  
Keywords Tuberculosis ◽  
Chronic Ulceration

Primary tuberculosis of the tongue is very rare. The chronic ulceration is commonly misdiagnosed as a cancerous lesion. We report the case of a 44 years old immunocompetent woman who presented with a lingual chronic painful ulceration. The biopsy of the lesion showed a granulomatous inflammation, with caseous necrosis in the center. The ulceration healed after a 6 month tuberculosis treatment. Keywords: Tuberculosis; oral; immunocompetence; ulcer.

Comparison of Polymerase Chain Reaction With Histopathologic Features for Diagnosis of Tuberculosis in Formalin-Fixed, Paraffin-Embedded Histologic Specimens

2003 ◽  
Vol 127 (3) ◽  
pp. 326-330 ◽  
Author(s):  
Do Youn Park ◽  
Jee Yeon Kim ◽  
Kyung Un Choi ◽  
Jin Sook Lee ◽  
Chang Hun Lee ◽  
...  
Keyword(s):  
Chronic Inflammation ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
Caseous Necrosis ◽  
Formalin Fixed Paraffin ◽  
Formalin Fixed Paraffin Embedded ◽  
Type Giant ◽  
Tb Pcr ◽  
Formalin Fixed ◽  
Histopathologic Features

Abstract Objective.—To investigate the relationship between various histopathologic features and the results of the tuberculosis (TB)–polymerase chain reaction (PCR) method in routinely submitted histologic specimens for the histopathologic diagnosis of TB. Design.—We used 95 formalin-fixed, paraffin-embedded tissue blocks from 81 patients who were clinically suspected of having TB. We assessed the presence of histopathologic features including well-formed granuloma, poorly formed granuloma, caseous necrosis, and Langhans-type giant cells. We performed nested PCR for IS6110 and Ziehl-Neelsen staining for acid-fast bacilli (AFB). Results.—Of the 81 patients studied, 53 patients had chronic granulomatous inflammation, whereas 28 patients had only chronic inflammation without definite granulomatous inflammation. Of the 53 cases with chronic granulomatous inflammation, 17 (32%) were AFB positive and 36 (68%) were TB-PCR positive. Among cases with chronic granulomatous inflammation, the percentage that were positive and negative by TB-PCR differed significantly with the presence of various histopathologic features. All of the 13 cases with well-formed granuloma, caseous necrosis, and Langhans-type giant cells were TB-PCR positive; however, 10 (36%) of the 28 cases with chronic inflammation without granulomatous lesions were also TB-PCR positive. Conclusions.—TB-PCR is a rapid, sensitive method for the diagnosis of TB in routinely processed formalin-fixed, paraffin-embedded histologic specimens and is readily available in histopathology laboratories. We recommend use of TB-PCR when TB is suspected clinically, especially in cases of chronic inflammation without definite evidence of granulomatous inflammation.

scholarly journals Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass

2018 ◽  
pp. bcr-2018-225436
Author(s):  
Sarah Pratt ◽  
Arthur Henderson ◽  
Stuart Gillett
Keyword(s):  
Mycobacterium Bovis ◽  
Systemic Treatment ◽  
Intestinal Tuberculosis ◽  
Granulomatous Inflammation ◽  
Clinical History ◽  
Giant Cells ◽  
Right Hemicolectomy ◽  
Caseous Necrosis ◽  
Detailed Clinical History ◽  
Progressive Weight Loss

An 80-year-old woman presented with dysphagia, odynophagia and progressive weight loss. Initial investigations suggested a large base of tongue squamous cell carcinoma. At panendoscopy, biopsies were taken which revealed granulomatous inflammation with multinucleated giant cells and areas of caseous necrosis. Acid-fast bacilli were identified on Ziehl-Neelsen stain and the appearances were consistent with Mycobacterium bovis. Closer inspection of the patient’s medical history revealed that she had previously undergone right hemicolectomy for an ascending colon stricture. The histology had shown granulomatous inflammation consistent with intestinal tuberculosis but no systemic treatment had been instigated at the time. This case highlights the importance of taking a detailed clinical history as well as the need to be cognisant of tuberculosis masquerading as cancer in the head and neck.

scholarly journals Primary tuberculosis of the tongue in an immunocompetent patient: A case report

2012 ◽  
Vol 2 (1) ◽  
pp. 78-79 ◽  
Author(s):  
Sant Parkash Kataria ◽  
Sneh Singh ◽  
Parul Tanwar ◽  
Sanjay Kumar ◽  
Gajender Singh
Keyword(s):  
Case Report ◽  
Immunocompetent Patient ◽  
Primary Tuberculosis

scholarly journals Exudative-constrictive tuberculous pericarditis in combination with arthritis in cardiologist practice: thoracoscopic biopsy as a diagnosis and treatment method

2018 ◽  
Vol 90 (9) ◽  
pp. 81-87
Author(s):  
O V Blagova ◽  
I N Alijeva ◽  
A V Nedostup ◽  
A N Kaburova ◽  
P V SenchihiN ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Granulomatous Inflammation ◽  
Treatment Method ◽  
Lymph Node Biopsy ◽  
Left Knee ◽  
Pericardial Cavity ◽  
Caseous Necrosis ◽  
Tuberculous Pericarditis ◽  
Negative Results ◽  
Thoracoscopic Biopsy

The goal is to present the possibilities of diagnosis verification, the features of the clinical picture of tuberculous pericarditis in the therapeutic clinic and the results of its treatment. Materials and methods. The paper presents clinical observation and a general analysis of 10 cases of tuberculous pericarditis in patients aged 31-79 (mean age 58.0 ± 15.1 years), 6 women and 4 men. Diagnostic puncture pericardium was performed on two patients, pleural puncture - on three Thoracoscopic biopsy of hilar lymph nodes and lung (n=1), pleura (n=1), supraclavicular lymph node biopsy (n=1). Dyskin test was carried out, as well as sputum examination, multispiral computed tomography, oncological search. Results. A 31-year-old patient with a massive effusion in the pericardial cavity, pleural lesion, arthritis of the left knee joint, whose results of the pericardial effusion and sputum were not diagnosed, tuberculosis was detected only with thoracoscopic biopsy of the lung and intrathoracic lymph nodes; the treatment via prednisolone and subtotal pericardectomy was performed. Among 10 patients with MSCT of the lung, changes were noted in general, but in only one case they were highly specific. Diaskin test is positive in 70%. In the study of punctata, bronchoalveolar flushing, Koch bacteria were not detected; at sputum in microscopy and biological sample BC was detected in two patients. The lymphocytic character of effusion in the pericardium / pleura is noted in 4 out of 5 cases. At a biopsy of lymphonoduses and a lung at 2 patients the picture of a granulomatous inflammation with a caseous necrosis. Pericarditis was predominantly large (from 2 cm and more) effusion, signs of constriction were noted in 50% of patients. Conclusion. Tuberculosis is one of the frequent causes of pericarditis in the Moscow therapeutic clinic. The most lymphocytic effusion with fibrin and the development of constriction. The negative results of all laboratory tests for tuberculosis do not exclude a diagnosis, It is necessary to use invasive morphological diagnostics, including thoracoscopic biopsy.

scholarly journals Paediatric Tuberculosis at a Referral Hospital in Istanbul: Analysis of 250 Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Ozden Turel ◽  
Selcen Kazanci ◽  
Ismail Gonen ◽  
Cigdem Aydogmus ◽  
Emel Karaoglan ◽  
...  
Keyword(s):  
Chart Review ◽  
Diagnostic Testing ◽  
Granulomatous Inflammation ◽  
Public Health Problem ◽  
Retrospective Chart Review ◽  
Caseous Necrosis ◽  
Contact Investigation ◽  
Physical Examinations ◽  
Paediatric Tuberculosis ◽  
Close Contacts

Background. Tuberculosis (TB) still remains a growing public health problem globally. TB in children is often diagnosed clinically.Methods. We conducted a retrospective chart review of children with TB from November 2004 through December 2010 to determine the appropriateness of using contact history and diagnostic testing.Results. A total of 250 children with TB were identified. One hundred and sixty-two children had only pulmonary disease while 39 had features of both extrapulmonary and pulmonary TB. Mean age was 7.8 years. Thirty-six patients had known contacts. The index case/cases were first-degree relatives in 75%. Sixteen patients who were symptomless were yielded by contact investigation of newly identified TB cases. Tuberculin skin test positivity was 53.3%. Acid-fast bacilli smear positivity was 13.1%, and culture positivity was 18.7%. Twenty-six patients had histopathology of nonrespiratory specimens (lymph nodes and other tissues) showing granulomatous inflammation and caseous necrosis consistent with TB.Conclusions. Presence of contact history directed us to search for TB in children with nonspecific symptoms even if physical examinations were normal. Some children who were close contacts to TB cases were identified to have TB before development of symptoms.

scholarly journals The Unexpected Diagnosis of Hepatic Tuberculosis in an Immunocompetent Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Nikolaos Garmpis ◽  
Christos Damaskos ◽  
Anna Garmpi ◽  
Aliki Liakea ◽  
Dimitrios Mantas
Keyword(s):  
Clinical Manifestations ◽  
Liver Lesion ◽  
Immunocompetent Patient ◽  
Histological Evaluation ◽  
Rare Entity ◽  
Liver Malignancies ◽  
Caseous Necrosis ◽  
Hepatic Tuberculosis ◽  
Right Lobe ◽  
Specific Symptoms

Background/Aim. Tuberculosis (TB) is a chronic infectious disease which affects millions. The most affected system is the respiratory. Thus, hepatic TB (HTB) without involvement of other organs is not common. Its clinical manifestations are not specific, and both imaging and histopathological findings are necessary for the diagnosis. The differential diagnosis includes primary and metastatic liver malignancies. Our aim is to describe the rare entity of HTB via a case presentation. Patient and Methods. We report a case of a 50-year-old female with abdominal pain, weight loss, fever, and anorexia. All imaging methods described a liver lesion. She underwent right lobe hepatectomy, and the histological evaluation demonstrated granuloma with central caseous necrosis. Results. Seven months postoperatively, the patient remains fit and healthy. Conclusion. HTB is a rare entity with no specific symptoms, signs, and no laboratory nor imaging findings. It can be managed effectively if diagnosed in time or lead to death if left untreated.

scholarly journals AB0944 TUBERCULOUS SEPTIC ARTHRITIS: CLINICAL FEATURES OF TWELVE CASES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1770.2-1771
Author(s):  
D. Khalifa ◽  
K. Baccouche ◽  
N. El Amri ◽  
H. Zeglaoui ◽  
E. Bouajina
Keyword(s):  
Septic Arthritis ◽  
Clinical Features ◽  
Granulomatous Inflammation ◽  
Synovial Biopsy ◽  
Mantoux Test ◽  
Caseous Necrosis ◽  
Mean Delay ◽  
Age Of Diagnosis ◽  
Triggering Factor ◽  
Delay Of Diagnosis

Background:Extrapulmonary forms of tuberculous septic arthritis account only for 1% of tuberculous infections. Although TB infection is rare in western countries, arthropathy is still a common problem in developing countries.Objectives:Describe clinical features of tuberculous septic arthritis seen by the rheumatologist.Methods:Retrospective descriptive study, lead in the rheumatology department of Farhat Hached Hospital, including medical files between 1999 and 2020. Data of patients diagnosed with tuberculous arthropathy were analysed.Results:Twelve patients were diagnosed with tuberculous septic arthritis. Six men and women were enrolled with a sex ratio of 1. The mean age of diagnosis was 47.5±16.16 years. Mean delay of diagnosis was 12.83±15.12 months. A triggering factor like a trauma was described in 8.3% and comorbidities were associated in 16.7% of the cases, mainly diabetes and chronic renal dysfonction. Type of pain was inflammatory in 91.7% of the time. The disease presented as a monoarthritis in 91.7% and an oligoarthritis in 8.3% of the cases. Chronic forms were observed in 91.7% and acute forms in 8.3% of the cases. Transmission was hematological in 60%, directly inoculated in 20% and secondarily disseminated from another site in 20% of the cases. Arthritis affected the knees in 50%, followed by the hips in 33.3% and then the ankles and wrist in 8.3% of the cases each. Fever was noted in 41.7% and general condition was altered in 50% of the patients. Chest radiographs showed the presence of infiltrates or micronodules in 33.3% of the patients. Bone erosions were detected in 66.7% of plain radiographs, while narrowing of the joint was seen in 83.3% and and juxta articular osteoporosis in 50% of the cases. MRI showed the presence of abces in 33% of the cases. The Mantoux test was positive in 2 cases, of which, one didn’t receive the recommended neonatal vaccine. Culture was positive in the synovial fluid in 25%, in sputum in 16.7%, and in urine in 8.3% of the cases. Synovial biopsy was performed for all patients. It showed a non specific synovial inflammation in 50%, granulomatous inflammation in 33.3% and caseous necrosis in 16.7% of the cases. Common quadri therapy was prescribed for all patients with a mean treatment duration of 11.41±1.37 months. Surgery was performed in only two cases with an uncontrolled infection under antibiotics. Disseminated tuberculosis accured in 33.3%, recurrence of the infection in the same site in 16.7% and extension to another articular localisation in 25% of the cases. One patient had a tuberculous meningoencephalitis leading to his death.Conclusion:Tuberculous septic arthritis is difficult to diagnose and should be recalled especially in endemic countries when dealing with chronic monoarthritis. Synovial biopsy is needed most of the time to confirm the diagnosis. Treatment is long and the disease may be complicated with fatal disseminated forms.References:[1]Foocharoen C, Nanagara R, Foocharoen T, Mootsikapun P, Suwannaroj S, Mahakkanukrauh A. Clinical features of tuberculous septic arthritis in Khon Kaen, Thailand: a 10-year retrospective study. Southeast Asian J Trop Med Public Health. nov 2010;41(6):1438-46.Disclosure of Interests:None declared

scholarly journals Cerebral phaeohyphomycosis due to Rhinocladiella mackenziei in an immunocompetent patient: A case report and review of literature

2020 ◽  
Author(s):  
Muhammad Mushtaq ◽  
Saad Bin Zafar Mahmood ◽  
Nosheen Nasir ◽  
Malik Saad Rashid ◽  
Memoona Irshad ◽  
...  
Keyword(s):  
Case Report ◽  
Granulomatous Inflammation ◽  
Immunocompetent Patient ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
Dematiaceous Fungi ◽  
Limb Weakness ◽  
Diagnostic Skills ◽  
Facial Numbness ◽  
Significant Mortality

Background and Purpose: Rhinocladiella mackenziei is a neurotropic fungus, which can cause devastating intracerebral infections with up to 100% fatality rate. It is difficult to isolate this fungus in laboratory as it grows slowly and requires diagnostic skills. Case report: A 42-year-old Pakistani man presented with headache, facial numbness, progressive upper limb weakness, and dysarthria. Magnetic resonance imaging of thebrain showed a space-occupying lesion in the basal ganglia region. The patient underwent supratentorial craniotomy for biopsy and excision. Histopathology of the specimen revealed granulomatous inflammation with abscess formation. Periodic acidSchiff special stains highlighted the presence of numerous septate fungal hyphae. The results revealed the growth of dematiaceous fungi, which were morphologically classified as R. mackenziei. The patient is currently stable and is being on amphotericin and posaconazole, along with neurorehabilitation therapy. Conclusion: Rhinocladiella mackenziei brain abscess is a devastating infection with significant mortality. This condition should be suspected in patients with brain abscessfrom high endemic areas

A RARE PERIODONTAL MANIFESTATION OF TUBERCULOSIS: REPORT OF TWO CASES

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Samit Javiya ◽  
Dr. Pallavi Sunil Bhailume ◽  
Dr. Ashok Bhansali ◽  
Dr. Harshal Bafna ◽  
Dr. Ripunjay Tripati ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Infectious Diseases ◽  
Cause Of Death ◽  
Communicable Diseases ◽  
The Body ◽  
Oral Lesions ◽  
Primary Tuberculosis ◽  
Keywords Tuberculosis ◽  
Tuberculous Osteomyelitis

Tuberculosis (TB) is one of the world’s deadliest communicable diseases. TB ranks the second leading cause of death from infectious diseases worldwide. It usually affects the lungs, TB bacilli can spread hematogenously to other parts of the body and this also includes mandible or maxilla. It can occur in the mouth involving the tongue with very unusual features and forms. So oral lesions, although rare, are very important for early diagnosis and interception of primary tuberculosis. Keywords: Tuberculosis, Tuberculous Osteomyelitis, Ulcers

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