Tuberculosis

oral Tuberculosis a chronic infectious disease caused by……… Mycobacterium tuberculosis. Worldwide, more than 2 billion people are infected with 9 million new cases and 3 million deaths per year Most infections are the result of direct person-to-person spread through airborne droplets from a patient with active disease

Primary tuberculosis…… occurs in previously unexposed people almost always involves the lungs. a nonspecific, chronic inflammatory reaction a localized, fibrocalcified nodule at the initial site of involvement. usually asymptomatic. Occasionally, fever and pleural effusion

secondary tuberculosis. Only about 5% to 10% of patients with tuberculosis progress from infection to active disease ( an immunosuppression often is responsible.) old age poverty crowded living secondary tuberculosis. Extrapulmonary tuberculosis Any organ system may be involved………. lymphatic system, skin, skeletal system, central nervous system, kidneys, gastrointestinal tract.

Oral Tuberculosis uncommon, most cases …………..a chronic painless ulcer. Less frequent presentations include ……… nodular, granular,or (rarely) firm leukoplakic areas.

1.Primary oral tuberculosis without pulmonary involvement is rare (almost always involves the lungs) Gingiva mucobuccal fold areas of inflammation adjacent to teeth in extraction sites.

2.secondary oral lesions Tongue (most) palate and lip

Area of granularity and ulceration of the lower alveolar ridge and floor of mouth

the differential diagnoses The chronic ulcerative form is the most common of these oral lesions the differential diagnoses Malignancies sarcoidosis syphilis aphthous lesion mycotic infection traumatic injury.

Histopathologic Features cell-mediated hypersensitivity reaction Granulomas infection…….. circumscribed collections of epithelioid histiocytes, lymphocytes, and multinucleated giant cells(langhans) often with caceous necrosis ( amorphous eosinophilic substance)

caceous necrosis

tubercles one of these granulomas is called a tubercle.

1-Langhans giant cell 2-Epitheloid cells