Analogies between HPV Behavior in Oral and Vaginal Cavity: Narrative Review on the Current Evidence in the Literature.

Human genital papilloma virus infection is the most prevalent sexually transmitted infection in the world. It is estimated that more than 75% of sexually active women contract this infection in their lifetime. In 80% of young women, there is the clearance of the virus within 18-24 months. In developed countries, oral squamous cell carcinoma (OSCC) is now the most frequent human papilloma virus (HPV)-related cancer, having surpassed cervical cancer, and it is predicted that by 2030 most squamous cell carcinomas will be the HPV-related rather than non-HPV-related form. However, there are currently no screening programs for oral cavity infection. While the natural history of HPV infection in the cervix is well known, in the oropharynx, it is not entirely clear. Furthermore, the prevalence of HPV in the oropharynx is unknown. Published studies have found wide-ranging prevalence estimates of 2.6% to 50%. There are also conflicting results regarding the percentage of women presenting the same type of HPV at two mucosal sites, ranging from 0 to 60%. Additionally, the question arises as to whether oral infection can develop from genital HPV infection, through oral and genital contact or by self-inoculation, or whether it should be considered an independent event. However, there is still no consensus on these topics, nor on the relationship between genital and oral HPV infections. Therefore, this literature review aims to evaluate whether there is evidence of a connection between oral and cervical HPV, while also endorsing the usefulness of the screening of oral infection in patients with high-risk cervical HPV as a means of facilitating the diagnosis and early management of HPV-related oral lesions. Finally, this review emphasizes the recommendation for the use of the HPV vaccines in primary prevention in the male and female population as the most effective means of successfully counteracting the increasing incidence of OSCC to date.

From the Oral Cavity to the Spine: Prevalence of Oral Cavity Infections in Patients with Pyogenic Spinal Infection.

Background incidence of pyogenic spinal infections has increased in recent years. In addition to treating the spinal infection, optimal care also includes identifying the source of the pyogenic spinal infection and the presence of other infections. The aim of this study is to elucidate the prevalence of oral cavity infection (OCI) within this patient cohort. Methods As part of a prospective study conducted from 2016 to 2021, the number of patients with dental infections was investigated by means of an orthopantomogram (OPG) and subsequent dental examination. Results The presence of an oral infection was investigated in 55 (47%) of 118 patients by an OPG, 29 (53%) of whom had a corresponding abnormality of the oral cavity. In addition to the spinal infection, patients with an oral cavity infection revealed an increased incidence of endocarditis, sepsis and brain abscess. A spinal epidural abscess, a multilevel affection of the infection, and an elevated CRP value were also found in patients with a co-existing oral cavity infection. Back pain assessed at admission and 3 months after surgery was also more pronounced in patients with an oral cavity infection. Neurological deficits were often present in patients with spinal and oral cavity infection. Conclusions The presence of an oral cavity infection has proven to be one of the important factors in the detection of the source of the pyogenic spinal infection. In addition, a pronounced spinal affection and frequent co-infections were seen in patients with an oral cavity infection.

Angina de Ludwig, aspectos semiológicos útiles para el diagnóstico presuntivo de una patología letal / Ludwig`s angina, useful semiologic points for the presumptive diagnosis of a lethal pathology

Resumen Mujer de 74 años consulta al servicio de urgencia por cuadro de sepsis origen aparentemente no precisado, hasta su evaluación por dermatología que describe eritema violáceo cervical anterior más una infección en cavidad bucal como puerta de entrada. Considerando la clínica y los estudios por imágenes confirmamos el diagnóstico de Angina de Ludwig, cuadro de alta morbimortalidad que puede progresar a otras complicaciones más graves. Finalmente la paciente evoluciona de manera tórpida no respondiendo a medidas realizadas de soporte y fallece. La Angina de Ludwig es una celulitis de evolución rápida y grave, muy poco frecuente, que por lo general tiene una puerta de entrada a través de infecciones de la mucosa oral, donde su sospecha obliga a iniciar terapia precoz con antibióticos, quirúrgico y soporte.

Abstract This is a 74-year-old female patient with comorbidities who consulted the emergency service due to symptoms of sepsis of apparently unspecified origin, until her evaluation by dermatology revealed mild anterior cervical violaceous erythema and probable dental infection as the portal of entry. Based on clinical and imaging findings, a diagnosis of Ludwig's angina is confirmed, a condition with high morbidity and mortality that can progress to other more severe complications. Finally, the patient had a torpid evolution, not responding to support measures, and died. Ludwig's Angina is a cellulitis of etiology, usually rapidly progressive, infrequent oral infections, where a mandatory physical examination should be considered and suspected in order to start early therapy.