HIV/TB co-infection: literature review and report of multiple tuberculosis oral ulcers.
ABSTRACT Human immunodeficiency virus/tuberculosis (HIV/TB) co-infected subjects demonstrate enhanced HIV replication and plasma viremia; CD4+ T-cell depletion; morbidity and mortality; and susceptibility to secondary bacterial and fungal infections compared to subjects solely infected with HIV. As the incidence of HIV/TB infection has been increasing, one would have expected to encounter oral lesions of tuberculosis more frequently. However, such oral lesions are uncommon. The lesions usually occur as ulcerations of the tongue. We report an additional case in an HIV/TB co-infected 39 year-old black male, who presented with chronic, painless, multiple oral ulcers, occurring simultaneously on the tongue, bilaterally on the palate and mucosa of the alveolar ridge. Microscopic examination confirmed the presence of chronic necrotizing granulomatous inflammation, with the identification of acid fast bacilli in the affected oral mucosal tissue. Anti-retroviral and anti-tuberculous treatment resulted in the resolution of the oral lesions. Confirmatory histopathological diagnosis following a biopsy is essential to determine the exact nature of chronic oral ulceration in an HIV individual and especially to distinguish between oral squamous cell carcimoma, lymphoma, infection (bacterial or fungal) and non-specific or aphthous type ulceration.
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ABSTRACT: We present a case of primary oral tuberculosis that led to the diagnosis of HIV infection. Our patient had clinically nonspecific ulcers on the labial mucosa and on the ventral surface of the tongue which were diagnosed as being tuberculous only on histological examination. This raised the suspicion of HIV infection that was subsequently confirmed by blood tests. The oral lesions resolved after 4 weeks of antituberculosis treatment. Some aspects of the pathogenesis of HIV-tuberculosis coinfection are discussed.Pathology research international. 01/2010; 2011:893295.
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ABSTRACT: Oral ulcers are generally painful lesions that are related to various conditions developing within the oral cavity. They can be classified as acute or chronic according to their presentation and progression. Acute oral ulcers are be associated with conditions such as trauma, recurrent aphthous stomatitis, Behçet's disease, bacterial and viral infections, allergic reactions or adverse drug reactions. Chronic oral ulcers are associated with conditions such as oral lichen planus, pemphigus vulgaris, mucosal pemphigoid, lupus erythematosus, mycosis and some bacterial and parasitic diseases. The correct differential diagnosis is necessary to establish the appropriate treatment, taking into account all the possible causes of ulcers in the oral cavity. In this second part of this two-part review, chronic oral ulcers are reviewed.Clinical and Experimental Dermatology 07/2009; 34(4):456-61. · 1.33 Impact Factor
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ABSTRACT: This chapter describes the techniques used to prepare a uniform and consistent mycobacterial culture and for the infection of macrophages in vitro. Here, protocols are described for the achievement of a certain number of single cell bacilli per macrophage. Confocal microscopy in combination with the software ImageJ are highlighted, and these techniques will be correlated with quantification by FACS and confirmed by colony forming units (CFU) the classical method to validate the intracellular survival of Mycobacterium tuberculosis. Conventional CFU for quantification of intracellular slow growing mycobacteria is labour-intensive, with incubation requirements that can take up to several weeks. New alternatives and fast methods are required for a rapid assessment of the immune response as well to test new antibacterial drugs in high-throughput screens.12/2010: pages 614-621; , ISBN: ISNN(13):978-84-614-6189-9