Primary tubercular osteomyelitis affecting the mandibular condyle - A case report

Abstract

Rationale: Primary orofacial tuberculosis (TB) accounts for <3% of all cases of TB. TB of the mandibular condyle is often misdiagnosed owing to its rarity. Patient Concerns: This report presents a 19-year-old female who presented with a painful swelling over the right preauricular region. The radiographic evaluation suggested a diagnosis of suppurative osteomyelitis of the condyle. Diagnosis: Clinically, the aetiology of the swelling was considered as infective. The histopathological examination of the resected specimen showed tuberculous granuloma and the polymerase chain reaction came positive. This confirms the diagnosis of tubercular osteomyelitis. Mantoux test and sputum acid-fast bacilli were found to be negative. Treatment: The patient was subjected to sequestrectomy with high condylectomy and systemic multidrug antitubercular regimen for 6 months. Outcomes: There was a resolution of infection postoperatively with subsequent regeneration of healthy bone. Take-away Lessons: Early identification and prompt diagnosis is imperative for better treatment outcomes.