Antineoplastics
1
Reactions 1070 - 24 Sep 2005 S Antineoplastics Oral infections: case report A 14-year-old boy developed oral bacterial and Candidia albicans infections during treatment with antineoplastics for acute lymphoblastic leukaemia (ALL). The boy had been receiving antineoplastics for varied intervals over 5 years [dosages not stated]; he had also received radiotherapy of the central nervous system. During treatment of a second ALL relapse, he was hospitalised with bacterial and mycotic infections on his face, abdomen and oral cavity [duration of treatment before reaction onset not clearly stated]. He reported fever, a progressive swollen face, and strong pain and burning in his mouth. On examination, he was pale, jaundiced, malnourished, cyanotic and had frequent fever, engorged cervical lymphadenitis and general aches and pains. He had right-sided facial asymmetry (he reported sporadic relapses) with erythematous and hyperpigmentated skin. On intraoral examination, he had ulcers in his palate with areas of extensive necrosis and pseudomembranes. Findings from gingival examination were characteristic of acute necrotising ulcerative gingivitis. His tongue was coated and had no papillae. He had foul mouth odour and limited mouth opening. Exfoliative cytology was performed and he was diagnosed with mixed infection with C. albicans and bacteria. The boy received imipenem and amphotericin B; mouthwash and removal of bacterial plaque were recommended. Discreet chronic gingivitis, carious white lesions and enamel hypoplasia were also observed in his teeth. Subsequently, he received oral prophylaxis with tartar removal and orientation and control of oral hygiene. Topical fluoride was applied until the carious white lesions disappeared. During remission phase of ALL, he continued to have right- sided facial pigmentation and discreet asymmetry, but had significant improvement in intraoral lesions. His tongue and palate mucosae returned to normal. Author comment: "During chemotherapy and radiotherapy there is an increase in the incidence and severity of infections and gingivitis, mainly during leukopenia periods with consequent immunosuppression." Gomes MF, et al. Oral manifestations during chemotherapy for acute lymphoblastic leukemia: a case report. Quintessence International 36: 307-313, No. 4, Apr 2005 - Brazil 807220912 1 Reactions 24 Sep 2005 No. 1070 0114-9954/10/1070-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Antineoplastics
Reactions 1070 - 24 Sep 2005
SAntineoplastics
Oral infections: case reportA 14-year-old boy developed oral bacterial and Candidia
albicans infections during treatment with antineoplastics foracute lymphoblastic leukaemia (ALL).
The boy had been receiving antineoplastics for variedintervals over 5 years [dosages not stated]; he had alsoreceived radiotherapy of the central nervous system. Duringtreatment of a second ALL relapse, he was hospitalised withbacterial and mycotic infections on his face, abdomen and oralcavity [duration of treatment before reaction onset not clearlystated]. He reported fever, a progressive swollen face, andstrong pain and burning in his mouth. On examination, he waspale, jaundiced, malnourished, cyanotic and had frequentfever, engorged cervical lymphadenitis and general aches andpains. He had right-sided facial asymmetry (he reportedsporadic relapses) with erythematous and hyperpigmentatedskin. On intraoral examination, he had ulcers in his palate withareas of extensive necrosis and pseudomembranes. Findingsfrom gingival examination were characteristic of acutenecrotising ulcerative gingivitis. His tongue was coated andhad no papillae. He had foul mouth odour and limited mouthopening. Exfoliative cytology was performed and he wasdiagnosed with mixed infection with C. albicans and bacteria.
The boy received imipenem and amphotericin B;mouthwash and removal of bacterial plaque wererecommended. Discreet chronic gingivitis, carious whitelesions and enamel hypoplasia were also observed in his teeth.Subsequently, he received oral prophylaxis with tartar removaland orientation and control of oral hygiene. Topical fluoridewas applied until the carious white lesions disappeared.During remission phase of ALL, he continued to have right-sided facial pigmentation and discreet asymmetry, but hadsignificant improvement in intraoral lesions. His tongue andpalate mucosae returned to normal.
Author comment: "During chemotherapy andradiotherapy there is an increase in the incidence and severityof infections and gingivitis, mainly during leukopenia periodswith consequent immunosuppression."Gomes MF, et al. Oral manifestations during chemotherapy for acutelymphoblastic leukemia: a case report. Quintessence International 36: 307-313, No.4, Apr 2005 - Brazil 807220912
1
Reactions 24 Sep 2005 No. 10700114-9954/10/1070-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
