RESUMO
Aspergillosis (a fungal infection by an organism of the Aspergillus species) of the oral cavity is an uncommon condition which most frequently occurs in immunocompromised patients, such as those with haematological malignancies. In such patients, prolonged neutropenia secondary to chemotherapeutic agents enables the spread of invasive aspergillosis, which is unaffected by anatomical barriers. Early detection and treatment of the condition is essential to avoid more serious complications, such as disseminated infection, which results in increased morbidity and mortality. This case report describes a patient with acute myeloid leukaemia who developed localized invasive Aspergillus flavus of the palate. High-dose antifungal therapy was instituted along with surgical removal of the involved tissues. Aspergillosis of the palate was successfully eradicated with no long-term ill effects from the treatment. Management of invasive aspergillosis includes early aggressive antifungal medication combined with surgical removal of the involved tissues.
Assuntos
Aspergilose/diagnóstico , Doenças da Gengiva/microbiologia , Leucemia Mieloide Aguda/complicações , Infecções Oportunistas/microbiologia , Palato/microbiologia , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/cirurgia , Terapia Combinada , Evolução Fatal , Seguimentos , Doenças da Gengiva/tratamento farmacológico , Doenças da Gengiva/cirurgia , Gengivite Ulcerativa Necrosante/microbiologia , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-Idade , Palato/efeitos dos fármacos , Palato/cirurgiaRESUMO
OBJECTIVE: We present the case of a 59-year-old Chinese patient with an unusual presentation of mucosal plasmacytosis involving the oropharynx, related to the use of toothpaste. METHOD: Case presentation and review of English medical literature involving mucosal plasmacytosis. RESULTS: Mucosal plasmacytosis is an uncommon disease process and has been associated with hypersensitivity reactions. Most cases involve the gingival mucosa, although there have been reports of cases involving other oral mucosal sites and the upper aerodigestive tract. Our case provides an example of oropharyngeal plasmacytosis related to toothpaste. A resolution of signs and symptoms followed withdrawal of the suspected allergens. CONCLUSION: Mucosal plasmacytosis is a benign inflammatory process that may appear to be more sinister on clinical examination. Skin patch testing is a useful adjunct in confirming the diagnosis.
Assuntos
Hipersensibilidade/etiologia , Neoplasias Orofaríngeas/patologia , Plasmocitoma/patologia , Cremes Dentais/efeitos adversos , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Mucosa/patologia , Neoplasias Orofaríngeas/etiologia , Plasmocitoma/etiologiaRESUMO
We present a case in which the patient had both bilateral shortening of the roots, and hemifacial atrophy. As far as we know, this combination has not been described before.
Assuntos
Hemiatrofia Facial/diagnóstico , Raiz Dentária/anormalidades , Adolescente , Diagnóstico Diferencial , Feminino , Humanos , Radiografia , Raiz Dentária/diagnóstico por imagem , Dente não Erupcionado/diagnóstico por imagemRESUMO
Significant orofacial complications of leukaemia in children include lymphadenopathy, spontaneous gingival bleeding, labial and lingual ecchymoses and mucosal petechiae, ulceration, gingival swelling, and infections. The dentist may be the first to notice signs of the illness. Treatment of leukaemia can result in serious orofacial problems which include oral mucositis and ulceration, infections, spontaneous gingival bleeding, neuropathy, xerostomia, and gingival hypertrophy. A prompt diagnosis leading to early intervention can decrease the morbidity and mortality of the disease and its treatment.
Assuntos
Antineoplásicos/efeitos adversos , Leucemia Mieloide Aguda/complicações , Doenças da Boca/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Transplante de Medula Óssea/efeitos adversos , Criança , Pré-Escolar , Humanos , Terapia de Imunossupressão/efeitos adversos , Leucemia Mieloide Aguda/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Radioterapia/efeitos adversosRESUMO
The treatment of a leukaemic child requires a multidisciplinary approach. The dental team should provide interceptive and preventive measures prior to the commencement of therapy whenever possible. During therapy, preventive and palliative measures are essential. Once remission is achieved, the child continues to have increased dental needs due to the effects of treatment. These needs may include an increased caries rate, dental maldevelopment, and secondary malignancy.