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Journal of Medical Case Reports

, 10:366

First Online: 20 December 2016Received: 06 May 2016Accepted: 24 October 2016DOI: 10.1186-s13256-016-1118-x

Cite this article as: Tellez-Rodriguez, J., Lopez-Fernandez, R., Rodriguez-Jurado, R. et al. J Med Case Reports 2016 10: 366. doi:10.1186-s13256-016-1118-x


BackgroundTuberculosis is considered an emerging disease worldwide; in the last 10 years, its incidence has increased to more than 9.6 million cases of active tuberculosis. In 2014, it resulted in 1.5 million patient deaths. However, oral presentation with bone involvement occurs in less than 3% of all reported cases and rarely arouses clinical suspicion on initial presentation.

Case presentationA 15-year-old Mexican girl who had a previous diagnosis of neurofibromatosis presented to our hospital with pain and swelling in the region of the left mandibular body since November 2011. A clinical examination revealed pain in the mandibular region, a mass of soft consistency that seemed to involve bone, and a fistula with discharge of intraoral purulent material. Additionally, tachycardia and hyperthermia were observed. The left submental and submandibular regions had a 12-cm-diameter swelling, which was well-delineated and nonerythematous. The final diagnosis was established by real-time polymerase chain reaction.

ConclusionsThe final diagnosis of rare cases of tuberculous osteomyelitis in the jaw can be established by deoxyribonucleic acid DNA identification of Mycobacterium tuberculosis in the lesion. Simple and fast complementary diagnosis by real-time polymerase chain reaction is a fundamental approach to establishing early and effective pharmacological and surgical treatment.

KeywordsTuberculosis Osteomyelitis Mycobacterium tuberculosis Jaw Case report AbbreviationsTcTechnetium-99 m

CTComputed tomography

MTBMycobacterium tuberculosis

NTMNontuberculous mycobacteria

PCRPolymerase chain reaction

qPCRQuantitative polymerase chain reaction

SPECTSingle-photon emission computed tomography







S-MTBSusceptible Mycobacterium tuberculosis

MTB-C+Mycobacterium tuberculosis-positive control

NTM-C+Nontuberculous mycobacteria-positive control

ICInternal control

NCNegative control


AFBAcid-fast bacilli

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Author: Jorge Tellez-Rodriguez - Rubi Lopez-Fernandez - Rodolfo Rodriguez-Jurado - Hayde Nallely Moreno-Sandoval - Francisco Martine


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