Subject(s)
Glossitis , Syphilis , Humans , Syphilis/pathology , Syphilis/diagnosis , Syphilis/complications , Male , Glossitis/pathology , Glossitis/microbiology , Adult , Middle AgedABSTRACT
Herpetic geometric glossitis is a unique morphologic variant of HSV (herpes simplex virus) type 1 infection on the dorsum of the tongue that presents as an extremely painful linear central lingual fissure with a branched pattern. in the center of the tongue; there is a branched pattern of fissures that extend bilaterally from the central linear fissure. Herpetic geometric glossitis has been reported in 11 patients; 8 of these individuals were immunocompromised. Medical conditions and immunosuppressive medication treatment (7 patients) or only medical disorders (3 patients) or neither (1 patient) were present. HSV type 1 infection was diagnosed by viral culture in (7 patients), Tzanck preparation (2 patients) or clinically (2 patients). Mucocutaneous HSV infection at non-lingual locations--including the lips, labial mucosa, face and chest--were observed in 5 patients. All patients' symptoms and lesions responded to treatment with oral antiviral therapy: acyclovir (9 patients), famciclovir (1 patient) or valacyclovir (1 patient). The lingual pain and dorsal tongue fissures completely resolved completely within two to 14 days. In summary, herpetic geometric glossitis is a unique HSV type 1 infection, usually in immunocompromised patients, that occurs on the dorsal tongue and responds completely after treatment with orally administered antiviral therapy.
Subject(s)
Antiviral Agents , Glossitis , Herpes Simplex , Herpesvirus 1, Human , Immunocompromised Host , Humans , Glossitis/drug therapy , Glossitis/virology , Middle Aged , Female , Male , Antiviral Agents/therapeutic use , Herpes Simplex/drug therapy , Herpes Simplex/diagnosis , Herpesvirus 1, Human/isolation & purification , Adult , Aged , Acyclovir/therapeutic use , Valacyclovir/therapeutic use , Valine/analogs & derivatives , Valine/therapeutic use , Famciclovir/therapeutic useABSTRACT
Aim - to improve the methodology for collecting material from lesions of the oral mucosa for exfoliative cytological examination. A group of patients diagnosed with B37.0 Candida stomatitis was examined. To clarify the diagnosis, various methods of collecting biological material from the tongue of patients were used, namely, the method using a cytobrush with subsequent fixation of cytological material on a slide. The microbiota of the back of the tongue was analyzed in 12 patients with glossitis and 12 healthy subjects (the control group). The microscopic method of research was used - using an immersion microscope MICROmed@XS-3330, and the morphological and tinctorial properties of microorganisms were determined. In ten fields of view, the number of leukocytes, the nature of epithelial cells, and the presence of various microorganisms were detected and counted. A comparison of the quality of the use of the microscope method for the study of the tongue microbiota of patients with candidal glossitis was performed under the conditions of taking pathological material using a dental scalpel and an oral cytobrush. For a reasonable interpretation of the results and determination of their significance, a statistical analysis was performed to determine the frequency of detection of microorganisms in patients with glossitis and healthy subjects, depending on the nature of the material taken from the back of the tongue using a dental scalpel or cytobrush. The studies showed that the etiologic structure of glossitis pathogens was dominated by Candida yeast-like fungi, but cases of leptotrichosis aetiology were observed (16.7%). Monococci and gram-negative monobacteria were detected in all studied groups. An increase in the diversity of microorganisms was found when the material was taken with a cytobrush. The microbiota of all subjects differed depending on the type of instrument used for sampling. Thus, in the group of healthy individuals, the interdental brush helped to detect twice as many streptococci as a scalpel. In patients with candidiasis, a brush biopsy showed a 2.7-fold increase in gram-positive diplococci, twice as many streptococci and gram-positive bacilli, three times as many staphylococci, 2.25 times as many clusterforming gram-negative cocci, and 2.3 times as many gram-negative diplococci. A significant increase in the diversity of microorganisms was observed with the cytobrush compared to the use of a dental scalpel. In patients with glossitis, the accumulation of keratinized epithelial cells was significantly higher compared to the presence of young cells in healthy subjects, regardless of the method of sampling.
Subject(s)
Mouth Mucosa , Tongue , Humans , Mouth Mucosa/microbiology , Mouth Mucosa/pathology , Tongue/microbiology , Tongue/pathology , Candida/isolation & purification , Male , Female , Microbiota , Glossitis/diagnosis , Glossitis/microbiology , Glossitis/pathology , Adult , Biocompatible Materials , Specimen Handling/methods , Candidiasis, Oral/diagnosis , Candidiasis, Oral/microbiology , Case-Control Studies , Middle AgedABSTRACT
A 9-year-old male Labrador retriever dog was presented with dysphagia and presence of hairs on the tongue. Buccal examination revealed ulcerative glossitis and lingual hairs along the midline. Ultrasound and magnetic resonance imaging of the tongue showed multiple hair shafts contained in a proliferative tissue along the midline and extending in a fistulous tract towards the right ventral aspect of the tongue at mid-length. Surgical excision was completed using a carbon-dioxide laser. Histopathological examination revealed a pyogranulomatous inflammation centered on growing hairs, confirming the diagnosis of glossitis and lingual hair heterotopia. At 10 mo after surgery, all clinical signs and glossitis had disappeared despite partial recurrence of hair on the dorsal sulcus and in the sublingual fistula. Key clinical message: Although lingual hair heterotopia usually has no clinical repercussions, associated ulcerative lesions should support imaging and biopsy.Resection of the lesion using a carbon-dioxide laser resulted in a good outcome in this case, but recurrent hair growth is possible.
Hétérotopie pilaire linguale associée à une glossite pyogranulomateuse chez un chien labrador : traitement chirurgical à l'aide d'un laser au dioxyde de carbone. Un chien Labrador mâle entier de 9 ans est présenté pour une dysphagie et la présence de poils sur la langue. L'examen de la cavité buccale met en évidence une glossite sévère associée à des implantations pilaires. L'échographie et l'imagerie par résonance magnétique de la langue mettent en évidence de multiples poils contenus dans du matériel tissulaire s'étendant le long de la ligne médiane et présentant un trajet fistuleux vers la partie ventrale droite de la langue à mi-longueur de cette dernière. Une exérèse est réalisée à l'aide d'un laser au dioxyde de carbone. L'examen histopathologique de la pièce d'exérèse révèle une inflammation pyogranulomateuse centrée sur des poils en croissance, confirmant le diagnostic de glossite et d'hétérotopie pilaire linguale. Dix mois après la chirurgie, aucun signe clinique n'est réapparu et la glossite a disparu, malgré la récidive partielle de poils sur la partie dorsale de la langue et en région sublinguale droite.Message clinique clé : Bien que l'hétérotopie pilaire linguale n'ait généralement pas de répercussion clinique, les lésions ulcéreuses associées devraient justifier une imagerie et une biopsie.La résection de la lésion à l'aide d'un laser au dioxyde de carbone a donné de bons résultats dans ce cas, mais une pousse récurrente des poils est possible.(Traduit par les auteurs).
Subject(s)
Dog Diseases , Glossitis , Animals , Male , Dogs , Glossitis/veterinary , Tongue , Hair , Carbon , Lasers , Dog Diseases/surgeryABSTRACT
BACKGROUND: The causes of vitamin B12 (B12) deficiency are varied and mainly related to gastric disorders. Glossitis is a common oral manifestation of B12 deficiency and is often first seen by dentists. This study aimed to investigate the correlation between B12 deficiency-related glossitis (B12-def glossitis) and gastric serum biomarkers [gastrin-17(G17), pepsinogen I (PGI), pepsinogen II (PGII), and anti-Helicobacter pylori (H. pylori) antibodies], and preliminarily discuss the etiology of B12-def glossitis. METHODS: A cross-sectional study was conducted in patients complaining of glossodynia, burning sensation, or severe recurrent oral ulcers, but patients with a history of gastrectomy were excluded. All subjects underwent a uniform oral examination and hematological tests. RESULTS: Of 243 patients, 133 with B12-def glossitis were in the case group, and 110 with other oral mucosal diseases (non-glossitis) and normal B12 levels were in the control group. In the case group, 84.2% (112/133) showed high G17 and low PGI levels (G17hi PGIlow ). Univariate logistic regression showed that G17hi PGIlow was a high-risk factor for B12-def glossitis (OR: 92.44; 95% CI: 35.91, 238.02). Subgroup analyses in the case group showed that the G17hi PGIlow group presented with lower B12 levels and a lower positive rate of anti-H. pylori antibodies compared to the non-G17hi PGIlow group. CONCLUSION: Gastric serum biomarkers in patients with B12-def glossitis generally showed G17hi PGIlow , suggesting possible atrophy of gastric corpus and fundus mucosa. The G17hi PGIlow and non-G17hi PGIlow groups may represent different etiologies of B12 deficiency.
Subject(s)
Gastrins , Glossitis , Helicobacter Infections , Humans , Pepsinogen A , Gastric Mucosa/pathology , Cross-Sectional Studies , Biomarkers , Glossitis/etiology , Glossitis/pathology , Helicobacter Infections/complications , Helicobacter Infections/diagnosisSubject(s)
Gastritis , Glossitis , Humans , Tongue , Glossitis/diagnosis , Glossitis/etiology , Gastritis/diagnosis , Gastritis/complicationsABSTRACT
Introduction: pernicious anemia is an autoimmune disease characterized by atrophic gastritis due to malabsorption of vitamin B12. Certain oral manifestations, such as Hunter´s glossitis and burning mouth syndrome, may precede the onset of this anemia. The aim of this study is to describe the clinical presentation, para-clinical aspects, the treatment, and the evolution of the pernicious anemia (PA) after treatment. Methods: retrospective study conducted at the Department of Haematology and Internal Medicine B of the Mohammed V Military Training Hospital in Rabat between January 2009 and December 2018. Thirty-four patients were enrolled with vitamin B12 deficiency, non-regenerative macrocytic anemia, a positive anti-intrinsic factor antibody and anti-parietal cell antibody and a histological diagnosis of atrophic gastritis in the presence or not of Helicobacter pylori. The qualitative variables were expressed in numbers and percentages, and the quantitative variables in mean and standard deviation. Multivariate analysis used the Fischer test; it was considered significant for a p < 0.05 value. Results: thirty-four cases were studied; the population study consists of 56% (n=19) of men and 44% (n=15) of women. The average age was 54.88± 9.14. The clinical manifestations of pernicious anemia are dominated by megaloblastic anemia 85.3% (n=29), followed by digestive 58.8%(n=20) and oral 55.9% (n=19) signs. Neurological manifestations were rarely found in 41% (n=14). Hunter´s glossitis 37% (n=7), stomatodynia 11% (n=2) were the most common oral manifestations accompanying pernicious anemia. The evolution was favorable in 79.4% (n=27) patients under substitution therapy with vitamin B12. Conclusion: dentists´ involvement in the diagnosis of pernicious anemia is based on changes in oral mucous membranes, which have been reported in 55.9% of all patients. These oral changes may occur in the absence of symptomatic anemia.
Subject(s)
Anemia, Pernicious , Gastritis, Atrophic , Glossitis , Military Personnel , Male , Humans , Female , Middle Aged , Anemia, Pernicious/complications , Anemia, Pernicious/diagnosis , Anemia, Pernicious/epidemiology , Retrospective Studies , Cross-Sectional Studies , Morocco , Vitamin B 12 , Autoantibodies , HospitalsABSTRACT
BACKGROUND: Simplexvirus humanalpha1 (HuAHV-1) are common anthropozoonosis reported in marmosets but rare in howler monkeys (Alouatta sp.). METHODS: Necropsy of two brown-howler monkeys (A. caraya) and one red-howler monkey (A. guariba clamitans) from different zoo collections were performed. Fragments of all organs were examined through microscopy. Samples were submitted to IHC for Simplexvirus humanalpha 2 (HuAHV-2) [sin. Herpesvirus simplex type 2] and PCR. RESULTS: Grossly, only the A. guariba showed liver lesions characterized by multifocal, pinpoint white areas corresponding microscopically as random necrotizing herpetic hepatitis and ulcerative glossitis. Both A. caraya showed necrotizing meningoencephalitis with Cowdry A-type body inclusions within neurons and astrocytes. Immunolabeling for HuAHV-1/2 was observed in the tongue, liver, and brain. HuAHV-1 was confirmed in all samples by PCR, Sanger sequencing, and phylogenetic analyses. CONCLUSION: Necrotizing meningoencephalitis was appreciated in 2/3 of animals, and it is associated with neurologic signs. Along with ulcerative glossitis, a hallmark lesion in marmosets, it was present in one animal. Regarding herpetic hepatitis, it is not frequent in monkeys and occurs mainly in immunocompromised animals. HuAHV-1 infection was confirmed corroborating with a human source. This is the second report on captive black-howler monkeys and the first gross, histologic, immunohistochemical, and molecular description of herpetic hepatitis and ulcerative glossitis in red-howler monkeys (A. guariba).
Subject(s)
Alouatta caraya , Alouatta , Glossitis , Hepatitis , Meningoencephalitis , Humans , Animals , Simplexvirus , Callithrix , PhylogenySubject(s)
Glossitis , Humans , Glossitis/etiology , Glossitis/drug therapy , Antiviral Agents/therapeutic useSubject(s)
Glossitis , Humans , Glossitis/etiology , Glossitis/drug therapy , Antiviral Agents/therapeutic useABSTRACT
BACKGROUND: Existing studies have reported the significant association between atrophic glossitis (AG) and hematinic deficiencies, including iron, folate and vitamin B12 deficiency. However, these findings were inconsistent. AG can be graded as partial or complete atrophy. It is still unclear whether hematinic deficiencies are associated with the grading of AG. METHODS: 236 AG patients and 208 sex- and age-matched healthy controls were enrolled in this study. Hematological tests including complete blood count, and serum levels of folate, ferritin and vitamin B12 were performed. The AG group was divided into those with partial AG and those with complete AG according to the extent of papillary atrophy. Statistical analysis was performed to assess whether hematinic deficiencies are risk factors for AG and its grading. RESULTS: Compared with the healthy controls, AG patients had significantly higher frequencies of vitamin B12 deficiency (68.22%), ferritin deficiency (13.98%) and anemia (21.61%). The differences in hematinic deficiencies and anemia between AG patients and healthy controls changed according to gender and age. The frequencies of serum vitamin B12 deficiency and anemia in the complete AG subgroup were significantly higher than those in the partial AG subgroup. Logistic regression analysis revealed that vitamin B12 deficiency and anemia were significantly correlated with AG and its grading. The AG patients with vitamin B12 deficiency responded well to supplement therapy. CONCLUSION: AG could be an important clinical indicator for potential vitamin B12 deficiency, especially when the degree of tongue atrophy more than 50% and complete atrophy. Vitamin B12 deficiency might play an etiological role in the development of AG.
Subject(s)
Anemia , Glossitis , Hematinics , Hyperhomocysteinemia , Vitamin B 12 Deficiency , Humans , Glossitis/etiology , Parietal Cells, Gastric/chemistry , Case-Control Studies , Erythrocyte Indices , Hemoglobins/analysis , Hyperhomocysteinemia/complications , Autoantibodies , Vitamin B 12 Deficiency/complications , Vitamin B 12 , Anemia/complications , Folic Acid , Tongue/pathology , Atrophy/pathology , FerritinsABSTRACT
A 9-year-old spayed female 18.8 kg mixed breed boxer dog was referred for evaluation of a 7-month history of difficulty swallowing and prehending food, regurgitation, hypersalivation, and an abnormal dorsiflexion of the tongue. Prior to referral, a barium study was performed, which revealed a mildly dilated esophagus. Treatment with sucralfate, cisapride, and prednisone was initiated. Physical examination revealed bilateral, symmetric atrophy of the temporalis muscles, dorsiflexion of the distal aspect of the tongue with concurrent muscle atrophy, and a reduced gag reflex. Electrodiagnostic examinations revealed spontaneous electrical activity in the muscles of mastication and tongue. Biopsies from the right temporalis, tongue, and biceps femoris muscles were collected. An immune-mediated myositis with fibrosis, scattered CD3, CD4, and CD8+ T-lymphocytes, and upregulation of markers for major histocompatibility antigens were observed in the tongue and temporalis muscles. The dog was treated with a tapering course of prednisone over 2 months and cyclosporine long-term. The dog was maintained on cyclosporine alone for > 2 years and clinical signs remained static, although multiple episodes of aspiration pneumonia occurred. Ultimately, euthanasia was performed due to chronic kidney disease with associated anemia, lethargy, and anorexia.
Glossite chez un chien âgé non-corgi : diagnostic et suivi à long terme. Une chienne boxer de race mixte de 18,8 kg stérilisée âgée de 9 ans a été référée pour l'évaluation d'une histoire de 7 mois de difficulté à avaler et de préhension des aliments, de régurgitation, d'hypersalivation et d'une dorsiflexion anormale de la langue. Avant la référence, un examen baryté a été réalisée et a révélé un oesophage légèrement dilaté. Un traitement par sucralfate, cisapride et prednisone a été initié. L'examen physique a révélé une atrophie bilatérale et symétrique des muscles temporaux, une flexion dorsale de la face distale de la langue avec atrophie musculaire concomitante et un réflexe nauséeux réduit. Les examens électrodiagnostiques ont révélé une activité électrique spontanée dans les muscles de la mastication et de la langue. Des biopsies des muscles temporaux droits, de la langue et du biceps fémoral ont été recueillies. Une myosite à médiation immunitaire avec fibrose, des lymphocytes T CD3, CD4 et CD8+ dispersés et une régulation positive des marqueurs des principaux antigènes d'histocompatibilité ont été observées dans la langue et les muscles temporaux. Le chien a été traité avec une posologie décroissante de prednisone sur 2 mois et de cyclosporine à long terme. Le chien a été maintenu sous cyclosporine seule pendant > 2 ans et les signes cliniques sont restés stables, bien que plusieurs épisodes de pneumonie par aspiration se soient produits. En fin de compte, l'euthanasie a été pratiquée en raison d'une maladie rénale chronique associée à une anémie, une léthargie et une anorexie.(Traduit par Dr Serge Messier).
Subject(s)
Cyclosporins , Dog Diseases , Glossitis , Tongue Diseases , Animals , Dog Diseases/diagnosis , Dog Diseases/drug therapy , Dog Diseases/pathology , Dogs , Female , Follow-Up Studies , Glossitis/diagnosis , Glossitis/pathology , Glossitis/veterinary , Prednisone/therapeutic use , Tongue/pathology , Tongue Diseases/veterinaryABSTRACT
BACKGROUND Adverse events following immunization (AEFIs) remain under recognized, particularly when the symptoms experienced are uncommon and mimic natural disease. In the context of the worldwide effort to provide protection against SARS-CoV-2 using multiple doses of vaccination and with the availability of multiple vaccines, the early recognition and prompt treatment of AEFIs has increased importance, as does the ability to carefully select an alternative after an AEFI occurs. CASE REPORT A 60-year-old woman presented for clinical immunology review with a 9-month history of glossitis and xerostomia. Onset of symptoms occurred following her first vaccination with a COVID-19 vaccine (BNT162b2). After partial interval improvement, her symptoms progressively worsened after a second vaccination and third booster vaccination with BNT162b2. While undergoing reviews from multiple specialists for possible underlying connective tissue disease, and with other causes of her symptoms being excluded, the patient's symptoms progressed, with worsening tongue swelling with new fissuring and xerostomia. The patient experienced an unintentional weight loss of 8 kg due to oral discomfort. It was only after this time that an AEFI was considered the cause of her presentation, after all other diagnostic considerations were considered unlikely. Targeted, symptomatic, localized treatment with topical oral corticosteroids was initiated, followed by a gradual tapering regimen, with excellent response. CONCLUSIONS This case highlights the need to consider AEFIs early in the differential diagnosis of unusual presentations and the importance of considering a trial of targeted symptomatic treatment for patients, even if diagnostic uncertainty remains.
Subject(s)
BNT162 Vaccine , COVID-19 , Glossitis , Xerostomia , Adverse Drug Reaction Reporting Systems , BNT162 Vaccine/adverse effects , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Glossitis/etiology , Humans , Middle Aged , SARS-CoV-2 , Vaccination/adverse effects , Xerostomia/etiologyABSTRACT
CASE HISTORY: A 3-year-old, intact female mixed-breed dog, weighing 7â kg, was presented with generalised swelling of the tongue, leading to impaired deglutition and episodes of dyspnoea. From the age of 2 years, the dog had been under immunosuppressive therapy due to atopic dermatitis. CLINICAL FINDINGS AND TREATMENT: Multiple nodular lesions at the apex of the tongue were noted as well as mandibular and retropharyngeal lymph node enlargement. Serum biochemistry results showed inflammatory changes. The results of several biopsies taken over 7 months indicated persistent pyogranulomatous and necrotising glossitis despite ongoing antimicrobial treatment, first with amoxicillin/clavulanic acid and then pradofloxacin. No foreign material, acid-fast bacteria or fungal hyphae were detected throughout. The final diagnosis of Mycobacterium avium subsp. hominissuis (Mah) was reached after PCR and bacterial culture were carried out on the third biopsy sample. Therapy was initiated with rifampicin, clarithromycin and doxycycline, leading to complete remission of the lesions. DIAGNOSIS: Severe chronic pyogranulomatous and necrotising glossitis associated with infection by Mah. CLINICAL RELEVANCE: This report describes challenges in the diagnosis and therapy of a localised Mah infection in an iatrogenically immunocompromised dog. Successful treatment was only achieved with a specific combination of antibiotics administered long-term. ABBREVIATIONS: AF: Acid-fast; ALP: Alkaline phosphatase; CT: Computed tomography; MAC: Mycobacterium avium complex; Mah: Mycobacterium avium subsp. hominissuis.
Subject(s)
Dog Diseases , Glossitis , Alkaline Phosphatase , Amoxicillin , Animals , Anti-Bacterial Agents , Clarithromycin , Clavulanic Acid , Dog Diseases/diagnosis , Dog Diseases/drug therapy , Dogs , Doxycycline , Female , Glossitis/diagnosis , Glossitis/drug therapy , Glossitis/veterinary , Immunomodulation , Mycobacterium , Mycobacterium avium , RifampinABSTRACT
OBJECTIVE: The aim: To identify characteristic features of structural change of the dorsal part of the mucous membrane of the tongue (MMT) in experimental streptozotocin-induced diabetes (ESID). PATIENTS AND METHODS: Materials and methods: The study included 20 adult white male rats of Vistar line (body weight 180-200 g), which were equally divided into 2 groups: experimental (simulated streptozotocin diabetes mellitus) and control ones. RESULTS: Results: 8 weeks after the beginning of ESID modeling, the changes in MMT are particularly pronounced. A large number of lamellar structures and keratin conglomerates are found on the surface of MMT. This phenomenon is closely correlated (r=0.70) with a decrease in the absorption capacity of superficial epitheliocytes and an increase in the number of heterogeneous microflora on the impression smear with low activity of leukocyte elements. The number of epitheliocytes of differentiation stages I-III continues to increase, and the number of epitheliocytes of differentiation stages IV-VI diminishes, which leads to a significant decrease in the index of cell differentiation and an increase in the nuclear-cytoplasmic ratio. Such changes in MMT impression smears indicate active processes of epithelial desquamation with increasing duration of ESID. CONCLUSION: Conclusions: Thus, the morphological changes of MMT in ESID are characterized by a diverse combination of atrophic and hyperplastic processes, resulting in uneven thickening of multilayered squamous epithelium. There are pronounced dystrophic changes in the epitheliocytes of the stratum corneum (dyskeratosis, parakeratosis) in the area of the taste buds. All areas of MMT are inflamed which indicates the development of diabetic glossitis.