Tuberculosis

Epidemiology

There is an increase in the number of tuberculosis cases in the United States as a result of the epidemic of acquired immune deficiency syndrome (AIDS). This increase also includes an increase in the number of extrapulmonary manifestations. It is believed that about 30% of patients with tuberculosis in the United States have AIDS. Conversely, 5 to 9% of patients with AIDS have tuberculosis. Tuberculosis with primary involvement of the masticator space is very rare. The masticator space may be affected by lesions originating from adjacent structures.

Clinical Findings

Tuberculosis of the masticator space may be overshadowed by the manifestations of AIDS or disseminated tuberculosis. Signs and symptoms of secondary masticator space involvement depend on the site of the lesion.

Pathology

Tuberculosis is caused by Mycobacterium tuberculosis, which can either be seen microscopically as acid-fast bacilli or demonstrated by culture. In adults, tuberculosis is most often a postprimary infection, whereas in children it is usually a primary event. In the head and neck, tuberculosis typically produces noncaseating granulomas in the lymph nodes, larynx, bones, or muscles.