Tuberculosis

Tuberculosis is an infective pathology with a chronic progression; it is caused by Mycobaterium tubercolosis. The disease has been known for centuries but it experienced a marked decrease during the 20th century, particularly in industrialised countries, thanks to the use of: antibiotics, vaccinations and improved, socio-economic conditions. In the last twenty years or so, there has been a fresh outbreak of cases on account of an increase in the pathology which causes an immune deficit (such as AIDS) and the drug-related resistance of certain strains of antibiotics.
The infection is particularly prevalent: it has been calculated that one third of the worldwide population has been exposed to the tubercular pathogen. The inter-human contagion is transmitted by tiny drops of spray (saliva or a dry cough) by an affected individual when the pathogen is active.
Primary tuberculosis is nearly always asymptomatic. Generally, the only clinical symptom is a fibro-calcified nodule, located in the primary site of colonization. Approximately, one tenth of latent infections develop into the fully-developed disease. Typical symptoms include: a chronic cough with blood-marked sputum, persistent mild fever, weight loss, asthenia and anorexia.
Secondary tuberculosis invariably occurs in the lungs but its presence outwith the lungs is not rare. It is present mainly in HIV- positive patients with infections in: the skin and mucosa, central nervous system, the lymphatic system, skeletal system, kidneys and various gastro-intestinal tracts. Oral lesions are rare (0.5% – 5%), presenting as manifestations of primary tuberculosis (due to the ingestion of foodstuffs from infected animals) and, more frequently, secondary tuberculosis due to direct exposure of infected sputum. Often the lesions are ulcerated, chronic and not particularly painful. Nodular, granulomatous and leukoplakic lesions are rarely present.
The most affected sites are the tongue, palate and lip. Diagnosis is predominantly by bacterial culture (in order to identify the bacterium) and molecular biology techniques, such as a polymerase chain reaction. Treatment can also involve four classes of various combinations of antibiotics: “RIS” (Rifampicin, Isoniazide and Streptomycin) and Ciprofloxacin.