PRIMARY ORAL TUBERCULOSIS PRESENTING AS A TONGUE ULCER

Abstract

Primary tuberculosis of the oral cavity is an extremely rare condition accounting for less than 1% of the extrapulmonary cases. A 36-year-old male patient was referred for consultation complaining of dysphonia and dysphagia associated with a painful nonhealing lesion in the tongue for approximately 60 days. Physical examination revealed a well-defined ulcer affecting the tongue apex. The patient reported the use of topic corticosteroids for over 30 days without any improvement. Hematologic exams were within normal limits and serologic tests for HIV, syphilis, and hepatitis were negative. Incisional biopsy was performed, and histopathologic examination revealed a granulomatous inflammatory process composed of multinucleated giant cells, epithelioid histiocytes, and lymphocytes. A Ziehl-Neelsen stain showed the presence of acid-fast bacilli, compatible with mycobacteria. No chest imaging alterations nor previous respiratory symptoms were present. Sixty days after starting antituberculous treatment, the patient showed complete healing of the lesion.