RESUMO
BACKGROUND: Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated. RESULTS: A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis. CONCLUSIONS: Although uncommon, PCM and OSCC should be considered as a diferential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Iincisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.
Assuntos
Carcinoma de Células Escamosas , Paracoccidioidomicose , Neoplasias da Língua , Humanos , Masculino , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Paracoccidioidomicose/diagnóstico , Idoso , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Neoplasias da Língua/diagnóstico , Úlceras Orais/diagnóstico , Úlceras Orais/microbiologia , Úlceras Orais/etiologia , Doenças da Língua/diagnóstico , Doenças da Língua/microbiologia , Adulto , Idoso de 80 Anos ou maisRESUMO
AIM: Mucormycosis is a rare human infection associated with Mucorales, a group of filamentous moulds found in different environmental niches. Its oral manifestations may occur in the mandible and tongue despite being rare. We aimed to systematically review the data on clinical manifestations, risk factors, diagnostic approaches, treatment options, and outcomes of mandibular and tongue mucormycosis. METHODS: An electronic search of articles published between January 1975 and November 2022 in PubMed, Web of Science, and EMBASE databases was performed. A total of 22 articles met the inclusion criteria and reported 27 cases of oral mucormycosis in total. RESULTS: Fourteen patients had mandibular mucormycosis signs unrelated to COVID-19 infection, 6 had SARS-CoV-2-related mandibular mucormycosis, and 6 had manifestations in the tongue. All published case reports during the COVID-19 pandemic were from India. Patient ages ranged from 4 months old to 82 years, and most patients had important comorbidities, such as blood dyscrasias related to immune deficiency and uncontrolled type 2 diabetes mellitus. The signs and symptoms of mandibular and tongue mucormycosis varied from dental pain, loose teeth, and nonhealing sockets to dysphagia and paraesthesia of the lip. Some patients also reported trismus, draining sinus tract, and facial pain. The diagnosis of oral mucormycosis was based on a combination of clinical, radiographic, and histopathologic findings by demonstrating fungal hyphae in tissue specimens. In most cases, mucormycosis was managed with systemic amphotericin B, strict glycaemic control, and aggressive surgical debridement of infected tissue, minimising the progression of the fungal infection and thus improving the survival rate. In some cases, combined antifungal therapy, antibiotic therapy, and chlorhexidine mouthwashes were used successfully. CONCLUSIONS: Recognition of the signs and symptoms by oral care providers is pertinent for the early diagnosis and treatment of tongue and mandibular mucormycosis, and providers should be aware of the possibility of this opportunistic fungal infection in patients with COVID-19. A multidisciplinary approach is recommended for the management of this lethal infection.
Assuntos
COVID-19 , Mucormicose , Doenças da Língua , Humanos , Mucormicose/diagnóstico , Mucormicose/terapia , Mucormicose/complicações , Doenças da Língua/diagnóstico , Doenças da Língua/microbiologia , COVID-19/complicações , Antifúngicos/uso terapêutico , Doenças Mandibulares/diagnóstico , Idoso , Pessoa de Meia-Idade , Mandíbula , Fatores de Risco , Adulto , Idoso de 80 Anos ou mais , AdolescenteAssuntos
Dermatomicoses/microbiologia , Otopatias/microbiologia , Histoplasmose/complicações , Doenças da Língua/microbiologia , Idoso de 80 Anos ou mais , Dermatomicoses/tratamento farmacológico , Otopatias/tratamento farmacológico , Evolução Fatal , Histoplasmose/tratamento farmacológico , Humanos , Masculino , Insuficiência Renal Crônica/complicações , Doenças da Língua/tratamento farmacológicoAssuntos
Abscesso/diagnóstico por imagem , Actinomicose/diagnóstico por imagem , Edema/diagnóstico por imagem , Doenças da Língua/diagnóstico por imagem , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Abscesso/cirurgia , Actinomicose/tratamento farmacológico , Actinomicose/cirurgia , Adulto , Meios de Contraste , Diagnóstico Diferencial , Drenagem , Edema/tratamento farmacológico , Edema/microbiologia , Edema/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X/métodos , Doenças da Língua/tratamento farmacológico , Doenças da Língua/microbiologia , Doenças da Língua/cirurgiaAssuntos
Cancro/diagnóstico , Infecções por HIV/complicações , Sífilis/diagnóstico , Doenças da Língua/diagnóstico , Cancro/microbiologia , Cancro/patologia , Humanos , Masculino , Técnicas de Amplificação de Ácido Nucleico/métodos , Sífilis/patologia , Doenças da Língua/microbiologia , Doenças da Língua/patologiaAssuntos
Isquemia/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/complicações , Doenças da Língua/microbiologia , Língua/irrigação sanguínea , Idoso de 80 Anos ou mais , Evolução Fatal , Feminino , Humanos , Infecções Estafilocócicas/microbiologia , Língua/microbiologiaRESUMO
BACKGROUND: Lingual abscess is a rare clinical entity, with posterior involvement being much less common than anterior involvement. Typical inciting events include trauma or direct inoculation to the area. The clinical diagnosis can be difficult, and early imaging and specialist consultation should be pursued to make a definitive diagnosis and to prevent patient deterioration. CASE REPORT: We present a case of posterior lingual abscess in a 62-year-old man after he received antibiotic injections to the lower molars for periodontal disease. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Lingual abscess is a rare condition that is difficult to diagnose clinically. Misdiagnosis or delayed diagnosis can lead to acute airway compromise and increased morbidity.
Assuntos
Abscesso/microbiologia , Antibacterianos/uso terapêutico , Doenças Periodontais/complicações , Doenças da Língua/microbiologia , Abscesso/diagnóstico por imagem , Abscesso/tratamento farmacológico , Antibacterianos/administração & dosagem , Humanos , Injeções Intralesionais/efeitos adversos , Masculino , Pessoa de Meia-Idade , Doenças Periodontais/tratamento farmacológico , Doenças da Língua/diagnóstico por imagem , Doenças da Língua/tratamento farmacológicoAssuntos
Histoplasmose/diagnóstico , Úlceras Orais/diagnóstico , Doenças da Língua/diagnóstico , Idoso , Feminino , Histoplasma , Histoplasmose/complicações , Humanos , Mucosa Bucal/patologia , Úlceras Orais/etiologia , Úlceras Orais/microbiologia , Úlceras Orais/patologia , Língua/patologia , Doenças da Língua/etiologia , Doenças da Língua/microbiologia , Doenças da Língua/patologiaAssuntos
Antibacterianos/administração & dosagem , Penicilina G Benzatina/administração & dosagem , Atenção Primária à Saúde , Úlcera Cutânea/patologia , Sífilis/diagnóstico , Doenças da Língua/patologia , Adulto , Bochecha/patologia , Busca de Comunicante , Humanos , Injeções Intramusculares , Masculino , Nariz/patologia , Exame Físico , Minorias Sexuais e de Gênero , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/microbiologia , Sífilis/tratamento farmacológico , Sífilis/microbiologia , Doenças da Língua/tratamento farmacológico , Doenças da Língua/microbiologia , Resultado do TratamentoRESUMO
Histoplasmosis is an endemic systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. In immunocompromised patients, histoplasmosis generally occurs as an opportunistic disease, with dissemination to various organs. Cutaneous involvement is observed in 38% to 85% of cases, with oral mucosal involvement in 30% to 60% of cases. This article describes the case study of a 32-year-old woman who presented an extensive tongue ulcer due to histoplasmosis and had the HIV infection diagnosis based on laboratory tests requested by the dentist.
Assuntos
Infecções por HIV/diagnóstico , Histoplasmose/diagnóstico , Hospedeiro Imunocomprometido , Doenças da Língua/microbiologia , Adulto , Diagnóstico Diferencial , Feminino , HumanosAssuntos
Úlceras Orais/diagnóstico , Sífilis/diagnóstico , Doenças da Língua/diagnóstico , Idoso , Biópsia/métodos , Tecido Conjuntivo/microbiologia , Tecido Conjuntivo/patologia , Diagnóstico Diferencial , Humanos , Masculino , Úlceras Orais/microbiologia , Doenças da Língua/microbiologia , Treponema pallidum/isolamento & purificaçãoRESUMO
A 66-year-old woman presented with acute onset of fever, chills, and productive cough associated with right-sided chest pain. During a recent hospitalization for dyspnea, she had been diagnosed with Coombs-positive autoimmune hemolytic anemia and had been taking a tapering dose of prednisone starting approximately 6 weeks prior to admission. In the interim, her dyspnea had resolved on treatment with steroids. At the time of presentation, her prednisone dose was 40 mg. Additional medical history included VTE, for which the patient was receiving anticoagulation therapy, and steroid-induced diabetes mellitus. Many years earlier, she had been treated for TB in her home country. The patient had immigrated to Queens, New York, from a Nepalese village 8 years prior. While still in Nepal, she had worked on a farm and had been in close proximity to cows. In Queens, she lived with her family in a house with a small garden but had no pets. Recent travel included a visit to Nepal 9 months ago and a trip to Syracuse, New York, one month prior to presentation. She was a never smoker and did not consume alcohol.