Tuberculosis in the oral cavity with pulmonary and meningeal dissemination

Abstract

Objective: to present one of the most atypical forms of presentation of tuberculosis with onset in the oral cavity and pulmonary and meningeal dissemination in a non-immunocompromised woman whose only known exposure risk factor was the performance of exodontia. Clinical case: case of a young adult woman who after exodontia presented a chronic ulcerated lesion in the oral cavity associated with weight loss and constitutional symptoms, without fever. She consulted multiple times to health centers with varied treatments, including antibiotics for a long time without improvement, and then consults our institution where incidentally diffuse pulmonary opacities associated with deterioration of consciousness, prostration in bed and fever, are documented. Histology and polymerase chain reaction (PCR) of oral cavity biopsy showed Mycobacterium tuberculosis with positive culture for the same microorganism in cerebrospinal fluid, documenting the case of primary tuberculosis in the oral cavity with pulmonary and meningeal dissemination in a patient whose only known risk factor was the presence of an exodontia. Conclusion: primary tuberculosis of the oral cavity is an infrequent type of tuberculosis, but in the presence of a chronic oral mucosal lesion tuberculosis as a differential diagnosis should be considered, even in the absence of risk factors such as immunosuppression