Orofacial tuberculosis mimicry of odontogenic abscess: A diagnostic dilemma!

Orofacial tuberculosis is a rare extrapulmonary form of tuberculosis without pathognomic signs and symptoms. Due to its unusual clinical presentation, orofacial tuberculosis (TB) is more often misdiagnosed as other orofacial pathologies and presents a diagnostic challenge in dentistry. One such case is described in the present case report, where a paediatric patient presented with extraoral submandibular swelling that mimicked an odontogenic infection associated with a mandibular primary molar. The treatment plan was formulated considering the condition as an odontogenic infection, and an incision and drainage of the lesion was performed. However, the lesion showed no signs of healing even after medication and surgical management. Eventually, an incisional biopsy was performed, and the results suggested of Tuberculosis. Later, magnetic resonance imaging (MRI) of the neck revealed Tubercular Lymphadenitis of the left submandibular lymph node. As Paediatric Dentist, we should have a broad vision while treating such patients, as many times dentists are the primary health care providers to diagnose tuberculosis in a dental clinic setup through proper history and examination. Tuberculosis, being an endemic problem in a country like India, needs early diagnosis and management to prevent its spread and reduce the health-related burden in the community.