Volume 20, Number 4, December 2008
| | Necrotising Ulcerative Stomatitis in a Neutropenic Patient with Malignant Lymphoma |
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Hideyuki Suenaga, Hideto Saijo, Daichi Chikazu, Hisako Fujihara, Madoka Sugiyama, Kazumi Ohkubo, Ichiro Seto, Yoshiyuki Mori, Mitsuyoshi Iino, Tsuyoshi Takato
Department of Oral-Maxillofacial Surgery, Dentistry and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan
Abstract
Necrotising ulcerative stomatitis is a very rapid, destructive disease of the alveolar bone and gingiva. The rapid destruction leads to devastating facial defects and death, if it is not treated promptly. Candida albicans and Pseudomonas aeruginosa are frequent causes of disseminated infections among patients who are immunocompromised. This report is of a 72-year-old woman with diffuse large B-cell lymphoma, who developed acute necrotising ulcerative stomatitis and septic shock together with histopathological and microbiological evidence of C. albicans and P. aeruginosa infections. Gingival necrosis was managed by debridement to remove slough and irrigation with povidone iodine. All oral symptoms subsided following the initiation of antimicrobial therapy and debridement. The patient completed chemotherapy and achieved prompt remission. This report highlights the importance of prompt recognition, debridement, teeth extraction, scrupulous oral hygiene, appropriate antibiotic therapy, and nutritional support for immunocompromised patients with necrotising ulcerative stomatitis.
Key words: Candida albicans, Necrosis, Neutropenia, Pseudomonas aeruginosa, Septic shock, Stomatitis
Asian J Oral Maxillofac Surg. 2008;20:196-200.
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