Unusual Presentations of Tuberculosis in the Oral, Head, and Neck Region
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Authors
Devah L.A.
Cheng L.
Ali E.
Rodgers W.
Thusu S.
Miller-Molloy G.
Gupta R.
Bridges-Smith F.
Abraham D.
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Issue Date
2025
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Journal Article
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Introduction: The incidence of tuberculosis (TB) has been rising, particularly due to increasing resistance to anti-TB drugs. TB is the second leading infectious killer globally, after COVID-19, with a fatality rate of 1.3 million annually. London, especially Hackney and Tower Hamlets, has the highest TB incidence in the UK. While classic signs of TB are well known, the disease can present with subtle symptoms in oral, head, and neck clinics. This article highlights unusual cases to demonstrate these atypical clinical signs. Material(s) and Method(s):s: Oral, head, and neck TB lesions are rare but crucial for early diagnosis and treatment. Recognizing these presentations can improve patient outcomes. Result(s): Unusual TB presentations seen in our unit include:- Mandibular osteomyelitis mimicking squamous cell carcinoma Cystic mandibular expansion involving both cortical plates Persistent neck lump unresponsive to steroids Necrotic cervical lymph nodes Necrotic mediastinal lymph nodes Persistent cutaneous sinuses in the neck and presternal skin Negative or ambiguous Mantoux tests in previously treated TB patients TB in immunosuppressed patients (e.g., HIV, lymphoma) Despite a low overall incidence in the UK due to effective treatment, these cases highlight the importance of considering TB in differential diagnoses. Conclusion(s): TB in the oral, head, and neck regions, though rare, can mimic malignancies or non-TB infections, presenting a diagnostic challenge. The rise of drug-resistant TB and co-infection with HIV underscores the need for early diagnosis and prompt referral to respiratory specialists for effective management.Copyright © 2025
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International Journal of Oral and Maxillofacial Surgery
Volume
54