Tuberculosis of Temporomandibular Joint Presenting as Swelling in the Preauricular Region

Abstract

d p t i d l Extrapulmonary tuberculosis (EPTB) is defined as tuberculosis (TB) of organs other than the lungs, such as the pleura, lymph nodes, abdomen, genitourinary tract, skin, joints, bones, and meninges. EPTB constitutes 15% to 20% of all cases of TB among immunocompetent adults, and it accounts for more than 50% of the cases in human immunodeficiency virus (HIV)–positive individuals. Reports from different parts of the world indicate an increasing trend in the proportion of EPTB among all TB cases. The HIV pandemic, improved case recruitment because of expanding services, reduction in infectious TB, and immigration resulting in changing demographics have been cited as auses for the increasing proportion of EPTB. Therefore, t is imperative that clinicians recognize the clinical signs nd symptoms of EPTB, make a prompt and accurate iagnosis, and properly treat the disease. Osteoarticular TB is commonly seen in the spine nd the large weight-bearing joints, such as the hip, nee, and ankle. Joint involvement occurs by hemaogenous spread from a pulmonary, visceral, or lymph ode focus leading to bacterial colonization of vascuar cancellous bone, especially the epiphysis and meaphysis of long bones. Infection begins in the subhondral region and spreads to involve the cartilage, ynovium, and joint space. Although head-and-neck TB comprises nearly 10% of all extrapulmonary manifestations of the disease, TB of the oral cavity and the maxillofacial region is