A Case Report of a Tongue Ulcer Presented as the First Sign of Occult Tuberculosis

Seo-Yeong Kim; Jin-Seok Byun; Jae-Kap Choi; Jae-Kwang Jung


BMC Oral Health. 2019;19(67) 

In This Article


Tuberculosis (TB) is a chronic infectious disease usually caused by Mycobacterium tuberculosis (M. tuberculosis) that is transmitted by expelled infectious aerosol droplets of patient with active TB.[1] However, in majority of cases, those infections are suppressed by an effective immune response from the host; TB often becomes asymptomatic in latent state and is not generally contagious.[2] Approximately 5% of otherwise healthy adults will develop into active TB disease within 2 years.[3]

TB is classified clinically as pulmonary and extrapulmonary, depending on the area of infection.[4] The lung is the predominant site of TB, but any organ of the body may be involved. Extrapulmonary involvement in TB is uncommon, accounting for approximately 10 to 15% of all TB patients.[4] The lymph nodes are the second most common location of TB.[5] Oral TB has been generally regarded as a rare occurrence. It is estimated that only 0.05 to 5% of total TB cases may present with oral manifestations.[6] Oral manifestations usually present as superficial ulcers, patches, papillomatous lesions, or indurated soft tissue lesions.[7]

Early diagnosis and prompt treatment of TB is essential because a delay in diagnosis may have serious consequences due to the progressive and contagious nature of TB. Oral lesion can be the first manifestation of TB, even if it is rare.[8] Dentists could be the first health care professionals to recognize oral lesions of TB with unusual and abnormal progress.

A case of oral tuberculosis ulcer with poor response to topically applied steroids in a patient with latent TB is presented herein.