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Article: Volume 43 Number 5 Page 487 - June 2016

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  Dent Update 2016; 43: 487-490

Oral Radiology:  Non-Pulmonary Tuberculosis – A Case Report: Importance and Pitfalls of Diagnosis

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Abstract: A case of tuberculosis presenting as a neck lump is highlighted. Tuberculosis is on the increase. There are national and international strategies to improve the management of tuberculosis in the United Kingdom, and raising clinical awareness of tuberculosis is an important part of that strategy. Neck lumps can present in the dental setting and the differential diagnosis should include tuberculosis, with referral to an appropriate multidisciplinary team. Special tests to aid diagnosis are helpful but not completely discriminating. Tuberculosis is a notifiable disease and it must be treated by a designated specialist medical team.

Clinical relevance: Tuberculosis is a differential diagnosis for a persistent neck lump and clinicians should understand the problems of diagnosis and the importance of appropriate referral for treatment in the national and international strategy to reduce this disease.

Author notes: Hannah Pepper, OMFS ST3, MBChB, MRCS, (hbpepper@hotmail.com), Rebecca Davies, BChD, MSc, DDR, Consultant Dental and Maxillofacial Radiology, Ceri Hughes, FRCS(OMFS), FRACDS(OMS), Consultant Oral and Maxillofacial Surgery, Steve Thomas, FRCS(OMFS), FRACDS(OMS), Professor and Consultant Oral and Maxillofacial Surgery, Miranda Pring, PhD, FRCPath, Consultant Senior Lecturer Oral and Maxillofacial Pathology and Martin Hetzel, MD, FRCP, Consultant in Respiratory and General Medicine, Department of Oral and Maxillofacial/Head and Neck Surgery, Bristol Dental Hospital and Respiratory Medicine, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin Street, Bristol BS1 2LY, UK.

Objective: To increase the awareness of tuberculosis as a differential diagnosis of cervical lymphadenopathy in the dental setting to ensure rapid and appropriate referral.