Analysis of Clinical Misdiagnosis of Oral and Maxillofacial Tuberculosis

FAN Zongshang; MA Lishuang; FU Mingchen; HUANG Tao

doi:10.3969/j.issn.1002-3429.2024.16.002

Abstract：Objective To analyze the clinical characteristics,causes of misdiagnosis and preventive measures of oral and maxillofacial tuberculosis.Methods The clinical data of 2 patients with misdiagnosed oral and maxillofacial tuberculosis treated from February 2019 to May 2023 were retrospectively analyzed.Results One patient had restricted mouth opening(mouth opening＜3 cm),and the left mucosa was observed to be ulcerated with a worm like edge and covered with purulent secretions.Pathological examination in other hospitals indicated chronic inflammation,and anti-infection-resistant treatment was ineffective for 1 week.Chest X-ray and CT examinations were conducted in our hospital after admission,followed by biop-sy of the lesion tissue,which was confirmed as oral and maxillofacial tuberculosis.Due to a 0.8 cm×1.0 cm ulcer seen on the right side of the back of the tongue with a clear boundary resembling a bullet hole and mouse-bite edges,the patient was initially diagnosed as a traumatic oral ulcer combined with the symptoms of the patient,and anti-infection treatment was inef-fective.Further examination by chest X-ray,tuberculosis antibody,pathological biopsy and acid-fast staining confirmed the di-agnosis of oral and maxillofacial tuberculosis.The misdiagnosis lasted 12 d and 7 months,respectively.Both patients received anti-tuberculosis treatment after diagnosis.After 6 months,the oral erosion mucosa and tongue mucosa ulcer were healed,and the prognosis was good.Conclusion The symptoms of oral and maxillofacial tuberculosis are often atypical,and the misdiag-nosis rate is high.The diagnosis mainly depends on pathological examination.Complex cases should be comprehensively ana-lyzed by various methods,the medical history should be carefully consulted,tuberculosis lesions in other areas should be found,and pathological biopsy should be performed as soon as possible.In addition,experimental anti-tuberculosis therapy can be performed if necessary,so as to improve the diagnosis rate of the disease.