[Lingual tuberculosis revealing disseminated tuberculosis].
BACKGROUND
Tuberculous lesions of the oral cavity are uncommon. Most of cases are secondary to pulmonary disease and the primary form is rare.


METHODS
We report the case of a 64 year-old man, smoker, presenting a chronic ulcer of the tongue, with anorexia and important weight loss. The biopsy of this ulcer showed granulomatous inflammation and Langhans type giant cells, without necrosis. Ziehl-Nielsen stain was negative. Pulmonary lesions were subsequently detected (chest X-ray, CT-scan) and the disseminated tuberculosis was confirmed by a positive culture with acid-fast bacilli in urine, blood, and pulmonary sample. Antituberculosis treatment resulted in the complete resolution of the oral lesion.


CONCLUSIONS
Biopsy for histopathological diagnosis, acid-fast stains and culture, is essential to determine the exact nature of chronic oral ulceration to distinguish between oral malignancy, infectious (syphilis), traumatic, or aphthous ulcers. Tuberculosis of the tongue is a difficult diagnosis. However it should be searched for because treatment usually results in a rapid recovery.
Vidal
M
M
Service de médecine interne, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58, rue Montalembert, BP 69, 63003 Clermont-Ferrand cedex 01, France. magalividal@yahoo.fr
Delevaux
I
I
André
M
M
Marroun
I
I
Gavet
F
F
Voinchet
H
H
Palat
S
S
Kintossou
R
R
Gilain
L
L
Aumaître
O
O
D000995:Antitubercular Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D014060:Tongue Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016896:Treatment Outcome; D014393:Tuberculosis, Oral / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014456:Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*
D000995:Antitubercular Agents