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TUBERCULOSIS
SYPHILIS
ACTINOMYCOSIS
SCARLET FEVER
NOMA
LEPROSY
DYPHTHERIA
CAT – SCRATCH DISEASE
PYOGENIC GRANULOMA
TUBERCULOSIS
Tuberculosis is a chronic systemic infectious
disease of worldwide prevalence. It is a
granulomatous infection and is caused by
Mycobacterium tuberculosis or rarely by
Mycobacterium bovis
Tubercular Gingivitis
Small granulating ulcers or erosive
lesions with concomitant gingival
hyperplasia
Tuberculous osteomyelitis
Develop due to entry of organisms through
decayed tooth or due to hematogenous spread.
Pain, swelling, sinus/fistula formation, trismus,
paresthesia.
Tuberculosis of salivary gland
Generalized glandular swelling or abscess
formation along with pain, facial palsy & fistula
formation
Scrofula
Enlarged oropharyngeal lynphoid tissue
with involvement of cervical lymph nodes.
Caseous necrosis &numerous draining
fistula
Lupus vulgaris – Tuberculous involvement
of skin
Histopathology
Microscopic presentation is in the form of
granulomas, which are circumscribed lesions.
granulomas have a central area of caseous
necrosis surrounded by multinucleated giant
cells and epithelioid cells.Epitheloid cells are
macrophages.
The nuclei of multinucleated giant cells are
seen at the periphery, having a horse shoe
shaped arrangement and these cells are called
Langhans’ giant cells.
This is surrounded by a zone of lymphocytic
infiltration and fibrosis.
Tubercular organisms may be demonstrated in
the tissue sections by Ziehl – Neelsen or other
acid fast stains.
Investigations
The infant may have many or even no signs until 6-8 weeks of
life (delayed form).
Higoumenaki's sign
Enlargement of clavicle adjacent to the sternum
Saber shin
Scaphoid scapulae
Concavity of vertebral border of the scapulae
Clutton's joint
Painless synovitis and enlargement of joints, usually the knee
Saddle Nose
Saber Shins
Clutton’s Joints
Hutchinson's triad
Described by Sir Jonathan Hutchinson in
1858.
Defined the following three pathognomonic
diagnostic features
Hutchinson's teeth
Ocular interstitial keratitis
Eighth nerve deafness
Few patients exhibit all three features
Hutchinson's teeth
The infection alters the formation of both the anterior
teeth (Hutchinson's incisors) and the posterior dentition
(Mulberry molars, Fournier's molars, Moon's molars).
THORACIC FORM
Culturing of organisms
Histopathological diagnosis
Immunofluorescent techniques
Treatment