title: Primary oral tuberculosis in a patient with lepromatous leprosy: Diagnostic dilemma.
abstract: Pulmonary tuberculosis (TB) is the most common form of TB. Primary infection can also affect the pharynx, cervical lymph node, intestine, or oral mucosa. Historically, the observed incidence of concomitant infection with leprosy and TB is high. However, reports of concomitant infection in modern literature remain scarce. Most cases reported in the literature had borderline/lepromatous leprosy and pulmonary tuberculosis. Extrapulmonary tuberculosis is reported in only 3.2% of leprosy cases. To the best of our knowledge, this is the first case report of primary oral tuberculosis of the tongue in a patient with lepromatous leprosy with Type 2 lepra reaction. The patient was referred to Directly Observed Treatment, Short-Course clinic and started on Category I treatment. She received oral prednisolone for lepra reaction, which was subsequently tapered and stopped, however, she continued to receive other antileprotic drugs (thalidomide and clofazimine). The patient's general condition improved and she is on regular follow up.
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medicine and Research, Puducherry, India; Department of Microbiology, Velammal Medical College Hospital and Research Institute, Madurai, Tamil Nadu, India. Electronic address: vidhya.md@gmail.com.
authors.forename: Vithiya
authors.initials: V
authors.lastname: Ganesan
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medicine and Research, Puducherry, India.
authors.forename: Jharna
authors.initials: J
authors.lastname: Mandal
mesh_terms: D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002991:Clofazimine / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D009061:Mouth Mucosa / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D011239:Prednisolone / Q000627:therapeutic use; D013792:Thalidomide / Q000627:therapeutic use; D014059:Tongue / Q000382:microbiology / Q000473:pathology; D014393:Tuberculosis, Oral / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000893:Anti-Inflammatory Agents; D007917:Leprostatic Agents; D013792:Thalidomide; D011239:Prednisolone; D002991:Clofazimine
keywords: Co-infection; Leprosy; Oral tuberculosis