tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2022-100-2-48-52tiblj-1616Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL OBSERVATIONSЯзва языка как проявление ВИЧ-ассоциированного туберкулеза с множественной лекарственной устойчивостьюTongue Ulcer as a Manifestation of Secondary HIV-Associated Multidrug-Resistant TuberculosisКукурикаА. В.KukurikaA. V.

Кукурика Анастасия Владимировна - врач-фтизиатр.

Макеевка, ул. Сормовская, д. 7

Anastasia V. Kukurika - Phthisiologist.

7, Sormovskaya St., Makeevka

nastya_kukurika@mail.ruЮровскаяИ. А.IurovskaiaI. A.

Юровская Ирина Александровна - кандидат медицинских наук, доцент кафедры терапевтической стоматологии

Донецк, пр. Ильича, д. 16

Irina A. Iurovskaia - Candidate of Medical Sciences, Associate Professor of Therapeutic Stomatology Department.

16, Iliicha Ave., Donetsk

terstom@dnmu.ruЮровскаяЕ. И.IurovskaiaE. I.

Юровская Екатерина Игоревна - врач-фтизиатр

Донецк, пр. Ильича, д. 104а

Ekaterina I. Iurovskaia - Phthisiologist.

104a, Iliicha Ave., Donetsk

doctorstoptb@gmail.comГородской противотуберкулезный диспансерУкраинаMunicipal TB DispensaryUkraineГОО ВПО Донецкий национальный медицинский университет им. М. ГорькогоУкраинаM. Gorky Donetsk National Medical UniversityUkraineРеспубликанская клиническая туберкулезная больницаУкраинаRepublican Clinical Tuberculosis HospitalUkraine20221403202210024852Copyright © Кукурика А.В., Юровская И.А., Юровская Е.И., 20222022Кукурика А.В., Юровская И.А., Юровская Е.И.Kukurika A.V., Iurovskaia I.A., Iurovskaia E.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1616

Туберкулез языка относится к числу редких локализаций внелегочного туберкулеза. Приведен клинический случай туберкулезного глоссита на фоне легочного туберкулеза с множественной лекарственной устойчивостью у больного с ВИЧ-инфекцией 35 лет. Несмотря на относительно быструю верификацию диагноза, сложность клинической ситуации состояла в дифференциальной диагностике с неспецифическим поражением, отсутствием сведений о ВИЧ-статусе, выявлении лекарственной устойчивости микобактерий туберкулеза. Данный случай демонстрирует поэтапную диагностику и лечение туберкулезной язвы языка. Комплексное обследование с применением молекулярно-генетических, бактериологических, гистологических и лучевых методов диагностики способствовало своевременному назначению адекватной схемы противотуберкулезной терапии.

Tuberculosis of the tongue is one of the rare localizations of extrapulmonary tuberculosis. The article presents a clinical case of secondary tuberculous glossitis with concurrent multidrug-resistant pulmonary tuberculosis in a 35-year-old HIV-infected patient. Despite relatively rapid verification of the diagnosis, the clinical situation was difficult due to differential diagnosis with nonspecific lesions, unknown HIV status, and detection of drug resistance of Mycobacterium tuberculosis. This case illustrates the step-by-step diagnosis and treatment of tuberculous ulcers of the tongue and lungs. The comprehensive examination with the use of molecular genetic, bacteriological, histological, and X-ray diagnostic tools contributed to the timely prescription of the adequate anti-tuberculosis therapy regimen.

туберкулез языкаязва языкавнелегочный туберкулезМЛУ-ТБВИЧ-инфекциядифференциальная диагностикаtuberculosis of tonguetongue ulcerextrapulmonary tuberculosisMDR-TBHIV infectiondifferential diagnosisReferencesКукурика А. В. Туберкулезный глоссит – редкая внелегочная локализация // Juvenis Scientia. – 2021. – Т. 7, № 4. – С. 12-21.A.V. Kukurika Tuberculous glossitis is a rare extrapulmonary localization. Juvenis Scientia, 2021, vol. 7, no. 4, pp. 12-21. (In Russ.)Arora K. S., Garg S., Kaur P., Mohapatra S. Primary oral tuberculosis on the tongue mimicking squamous cell carcinoma // Indian J. Tuberc. ‒ 2018. ‒ Vol. 65, № 1. ‒ Р. 84-86.Arora K.S., Garg S., Kaur P., Mohapatra S. Primary oral tuberculosis on the tongue mimicking squamous cell carcinoma. Indian J. Tuberc., 2018, vol. 65, no. 1, pp. 84-86.Battista G., Lo Russo L., Padovano Di Leva A., Rubini C., Sberna M. T., Bollero R., De Santis D., D'agostino A., Bertossi D., Lo Muzio L. Oral tuberculosis: a tongue case report // Minerva Stomatol. ‒ 2013. ‒ Vol. 62 (4 Suppl. 1). ‒ Р. 75-81.Battista G., Lo Russo L., Padovano Di Leva A., Rubini C., Sberna M.T., Bollero R., De Santis D., D'agostino A., Bertossi D., Lo Muzio L. Oral tuberculosis: a tongue case report. Minerva Stomatol., 2013, vol. 62, 4 suppl. 1, pp. 75-81.Benitez B., Mülli J., Tzankov A., Kunz C. Traumatic ulcerative granuloma with stromal eosinophilia - clinical case report, literature review, and differential diagnosis // World J. Surg Oncol. ‒ 2019. ‒ Vol. 17, № 1. ‒ Р. 184.Benitez B., Mülli J., Tzankov A., Kunz C. Traumatic ulcerative granuloma with stromal eosinophilia - clinical case report, literature review, and differential diagnosis. World J. Surg. Oncol., 2019, vol. 17, no. 1, pp. 184.Boras V. V., Gabrić D., Smiljanić Tomičević L., Seiwerth S., Gršić K., Šarčević B., Lončar Brzak B., Marunica E., Glavina A. Tuberculosis of the oral cavity misdiagnosed as precancerous lesion // Acta Stomatol. Croat. ‒ 2017. ‒ Vol. 51, № 4. ‒ Р. 326-331.Boras V.V., Gabrić D., Smiljanić Tomičević L., Seiwerth S., Gršić K., Šarčević B., Lončar Brzak B., Marunica E., Glavina A. Tuberculosis of the oral cavity misdiagnosed as precancerous lesion. Acta Stomatol. Croat., 2017, vol. 51, no. 4, pp. 326-331.Deshpande A., Gupta P., Simha Reddy A. V., Ramachandra Reddy G. V. Atypical presentation of tuberculosis // J. Oral. Maxillofac. Pathol. 2020. ‒ Vol. 24, № 2. ‒ Р. 404.Deshpande A., Gupta P., Simha Reddy A.V., Ramachandra Reddy G.V. Atypical presentation of tuberculosis. J. Oral. Maxillofac. Pathol., 2020, vol. 24, no. 2, pp. 404.Dogra S. S., Chander B., Krishna M. Tuberculosis of oral cavity: a series of one primary and three secondary cases // Indian J. Otolaryngol. Head Neck Surg. ‒ 2013. ‒ Vol. 65, № 3. ‒ Р. 275-279.Dogra S.S., Chander B., Krishna M. Tuberculosis of oral cavity: a series of one primary and three secondary cases. Indian J. Otolaryngol. Head Neck Surg., 2013, vol. 65, no. 3, pp. 275-279.Fragoso J., Oliveira M. M., Gonçalves C., Méndez J., Sarmento-Castro R. Oral ulcer as presentation of cavitating pulmonary tuberculosis // IDCases. ‒ 2020. ‒ Vol. 1, № 22. ‒ Р. e00976.Fragoso J., Oliveira M.M., Gonçalves C., Méndez J., Sarmento-Castro R. Oral ulcer as presentation of cavitating pulmonary tuberculosis. IDCases, 2020, vol. 1, no. 22, pp. e00976.Gannepalli A., Krishna A. B., Baghirath P. V., Vinay B. H., Khaled S., Anjum B. Oral manifestations in HIV-TB co-infected patients and their correlation with CD4 count in Telangana State, India // J. Int. Soc. Prev. Community Dent. ‒ 2020. ‒ Vol. 10, № 1. ‒ Р. 21-35.Gannepalli A., Krishna A.B., Baghirath P.V., Vinay B.H., Khaled S., Anjum B. Oral manifestations in HIV-TB co-infected patients and their correlation with CD4 count in Telangana State, India. J. Int. Soc. Prev. Community Dent., 2020, vol. 10, no. 1, pp. 21-35.Gupta L., Bhatt A. S., Mallya V., Rana D., Khurana N., Singh I. Oro-facial tuberculosis ‒ Is it still an enigmatic entity? // Indian J. Pathol. Microbiol. ‒ 2021. ‒ Vol. 64, № 2. ‒ Р. 250-253.Gupta L., Bhatt A.S., Mallya V., Rana D., Khurana N., Singh I. Oro-facial tuberculosis ‒ Is it still an enigmatic entity? Indian J. Pathol. Microbiol., 2021, vol. 64, no. 2, pp. 250-253.Hamid R., Sharma P., Sheikh R. A., Bhat M. Primary oral tuberculosis: A case series of a rare disease // J. Oral. Maxillofac. Pathol. ‒ 2020. ‒ Vol. 24, № 2. ‒ Р. 332-338.Hamid R., Sharma P., Sheikh R.A., Bhat M. Primary oral tuberculosis: A case series of a rare disease. J. Oral. Maxillofac. Pathol., 2020, vol. 24, no. 2, pp. 332-338.Jain P., Adhikari A., Mandal P. K., Minz R. S. Tuberculosis of tongue, an enigma: Report of two cases. CHRISMED // J. Health Res. ‒ 2019. ‒ Vol. 6, № 2. ‒ Р. 117-118.Jain P., Adhikari A., Mandal P.K., Minz R.S. Tuberculosis of tongue, an enigma: Report of two cases. CHRISMED. J. Health Res., 2019, vol. 6, no. 2, pp. 117-118.Ju W., Fu Y., Liu Y., Tan Y., Dong M., Wang L. Clinical and pathologic analyses of tuberculosis in the oral cavity: report of 11 cases // Oral. Surg. Oral. Med. Oral. Pathol. Oral. Radiol. Endod. ‒ 2018. ‒ Vol. 125, № 1. ‒ Р. 44-51.Ju W., Fu Y., Liu Y., Tan Y., Dong M., Wang L. Clinical and pathologic analyses of tuberculosis in the oral cavity: report of 11 cases. Oral. Surg. Oral. Med. Oral. Pathol. Oral. Radiol. Endod., 2018, vol. 125, no. 1, pp. 44-51.Kim S. Y., Byun J. S., Choi J. K., Jung J. K. A case report of a tongue ulcer presented as the first sign of occult tuberculosis // BMC Oral. Health. ‒ 2019. ‒ Vol. 19, № 1. ‒ Р. 67.Kim S.Y., Byun J.S., Choi J.K., Jung J.K. A case report of a tongue ulcer presented as the first sign of occult tuberculosis. BMC Oral. Health, 2019, vol. 19, no. 1, pp. 67.Pasticci M. B., Floridi P., Schiaroli E., Stagni G. M., De Socio1 G. V., Longari F., Baldelli1 F. Lingual tuberculosis: a rare disease in Western countries // New microbiologica. ‒ 2012. ‒ Vol. 35. ‒ Р. 233-237.Pasticci M.B., Floridi P., Schiaroli E., Stagni G.M., De Socio1 G.V., Longari F., Baldelli1 F. Lingual tuberculosis: a rare disease in Western countries. New Microbiologica, 2012, vol. 35, pp. 233-237.Pratt S., Henderson A., Gillett S. Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass // BMJ Case Rep. ‒ 2018;2018:bcr2018225436.Pratt S., Henderson A., Gillett S. Disseminated tuberculosis caused by Mycobacterium bovis presenting as a tongue base mass. BMJ Case Rep., 2018;2018:bcr2018225436.Razem B., El Hamid S., Salissou I., Raiteb M., Slimani F. Lingual primary tuberculosis mimicking malignancy // Ann. Med. Surg. (Lond). ‒ 2021. ‒ Vol. 67. ‒ Р. 102525.Razem B., El Hamid S., Salissou I., Raiteb M., Slimani F. Lingual primary tuberculosis mimicking malignancy. Ann. Med. Surg. (Lond)., 2021, vol. 67, pp. 102525.Rodríguez J. Y., Rodríguez G. J., Álvarez-Moreno C. A. Lingual tuberculosis in an HIV/AIDS patient // Int. J. Infect. Dis. ‒ 2017. ‒ Vol. 58. ‒ Р. 43-44.Rodríguez J.Y., Rodríguez G.J., Álvarez-Moreno C.A. Lingual tuberculosis in an HIV/AIDS patient. Int. J. Infect. Dis., 2017, vol. 58, pp. 43-44.Saugat R., Soni G., Shivranjani R., Gujrani M., Thakral P., Kapoor A. Lingual tuberculosis mimicking malignant lesion: A rare manifestation of a common disease // J. Associat. Chest Physicians. ‒ 2016. ‒ Vol. 4, № 2. ‒ Р. 87-90.Saugat R., Soni G., Shivranjani R., Gujrani M., Thakral P., Kapoor A. Lingual tuberculosis mimicking malignant lesion: A rare manifestation of a common disease. J. Associat. Chest Physicians, 2016, vol. 4, no. 2, pp. 87-90.

The authors declare that there are no conflicts of interest present.