Human immunodeficiency virus/
tuberculosis (HIV/TB) co-infected subjects demonstrate enhanced HIV replication and plasma
viremia; CD4+ T-cell depletion; morbidity and mortality; and susceptibility to secondary bacterial and
fungal infections compared to subjects solely infected with HIV. As the incidence of HIV/TB
infection has been increasing, one would have expected to encounter oral lesions of
tuberculosis more frequently. However, such oral lesions are uncommon. The lesions usually occur as ulcerations of the tongue. We report an additional case in an HIV/TB co-infected 39 year-old black male, who presented with chronic, painless, multiple
oral ulcers, occurring simultaneously on the tongue, bilaterally on the palate and mucosa of the alveolar ridge. Microscopic examination confirmed the presence of chronic necrotizing granulomatous
inflammation, with the identification of
acid fast bacilli in the affected oral mucosal tissue. Anti-retroviral and anti-tuberculous treatment resulted in the resolution of the oral lesions. Confirmatory histopathological diagnosis following a biopsy is essential to determine the exact nature of chronic oral ulceration in an HIV individual and especially to distinguish between oral squamous cell carcimoma,
lymphoma,
infection (bacterial or fungal) and non-specific or aphthous type ulceration.