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Objective <p>To identify and report cases of exclusively primary orofacial tuberculous lesions and discuss their clinical presentation and management, with particular emphasis on initial diagnostic pitfalls.</p> Study Design <p>Retrospective study in which case records of patients presenting with primary orofacial tuberculous lesions without pulmonary involvement, confirmed by one or more diagnostic tests including sputum testing, smear microscopy, culture, and Xpert MTB/RIF assay were identified; relevant data were extracted and analysed.</p> Results <p>Nine patients were identified with an age range of 5 to 58 years. None had a co-existing illness. Seven cases were diagnosed as osteomyelitis, including two cases that uniquely involved zygoma, an uncommonly reported site in the literature. One case involved extra-sinus, extraoral maxillary supraperiosteal soft tissues, a presentation unlike previously described peri-maxillary involvement. An initial diagnosis did not include tuberculosis in 6 of the 9 cases, leading to unwarranted treatment interventions; prior experience enabled early tuberculosis confirmation without surgical intervention in the remaining 3 cases.</p> Conclusion <p>Clinicians practising in countries with a higher incidence of tuberculosis should include tuberculosis in the differential diagnosis of pathological orofacial lesions that do not respond to conventional treatment. Osseous involvement of the jaw in non-tooth-bearing areas, and a radiographic pattern of bone destruction progressing from outside to inside, are useful diagnostic indicators of tuberculous involvement.</p>

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Primary Orofacial Tuberculosis: An Institutional Experience of Rare Disease

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Mohammad Danish,
  • Sajjad Abdur Rahman,
  • Tabishur Rahman,
  • Mohammad Kalim Ansari,
  • Mohd Aswad Khan

摘要

Objective

To identify and report cases of exclusively primary orofacial tuberculous lesions and discuss their clinical presentation and management, with particular emphasis on initial diagnostic pitfalls.

Study Design

Retrospective study in which case records of patients presenting with primary orofacial tuberculous lesions without pulmonary involvement, confirmed by one or more diagnostic tests including sputum testing, smear microscopy, culture, and Xpert MTB/RIF assay were identified; relevant data were extracted and analysed.

Results

Nine patients were identified with an age range of 5 to 58 years. None had a co-existing illness. Seven cases were diagnosed as osteomyelitis, including two cases that uniquely involved zygoma, an uncommonly reported site in the literature. One case involved extra-sinus, extraoral maxillary supraperiosteal soft tissues, a presentation unlike previously described peri-maxillary involvement. An initial diagnosis did not include tuberculosis in 6 of the 9 cases, leading to unwarranted treatment interventions; prior experience enabled early tuberculosis confirmation without surgical intervention in the remaining 3 cases.

Conclusion

Clinicians practising in countries with a higher incidence of tuberculosis should include tuberculosis in the differential diagnosis of pathological orofacial lesions that do not respond to conventional treatment. Osseous involvement of the jaw in non-tooth-bearing areas, and a radiographic pattern of bone destruction progressing from outside to inside, are useful diagnostic indicators of tuberculous involvement.