DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.015

Pages: 928-930

Tuberculosis, caused by Mycobacterium tuberculosis, primarily manifests as pulmonary disease but can involve extrapulmonary sites in approximately 15–20% of cases. Osteoarticular tuberculosis is rare, and mandibular involvement remains an exceptional clinical finding that frequently mimics odontogenic infections or malignancies. This report describes an 11-year-old female presenting with a painful, right-sided mandibular swelling evolving over five months, associated with cutaneous fistulization and purulent discharge. Clinical and radiographic evaluations revealed aggressive, diffuse bone lysis initially suggestive of a tumor. Following negative sputum and chest radiographs, a diagnosis of tuberculous osteomyelitis was confirmed via histopathology and molecular testing (CBNAAT). The patient showed a remarkable recovery following a standard antituberculous regimen. This case underscores that tuberculous osteomyelitis should be considered in the differential diagnosis of chronic mandibular swellings resistant to conventional antibiotics. Early diagnosis through a multidisciplinary approach including molecular tests like Xpert MTB/RIF is essential to avoid unnecessary surgical morbidity and initiate life-saving therapy.