RESUMO
Kaposi sarcoma (KS) etiologically linked to Kaposi sarcoma-associated herpesvirus (KSHV) is the most common HIV associated cancer despite the generalization of antiretroviral therapy. Head, neck, and especially oral cavity are common and specific sites for lesions. Those oral lesions contain a high viral load of KSHV virus and are one of the signs of disease severity. The development of KS in HIV-infected patients is classically described in case of low CD4 count, but recently reported cases revealed oral KS despite a robust CD4 count, such observations being possibly linked to interactions between periodontal germs and the oncogenic KSHV virus. We present two cases of KS location on the oral mucosa in HIV patients with gingival inflammation despite efficient antiretroviral treatment and immune restoration. Those cases suggest that the diagnosis of oral KS lesions should be considered by oral surgeons, dermatologists, and infectious specialists, when managing any suspicious lesion in an HIV patient, even with undetectable HIV viral loads, or in a seronegative patient with unprotected sexual activity. Key words:Kaposi Sarcoma, KSHV, HIV infection, CD4 count, oral lesion, oral cancer, periodontal pathogens.
RESUMO
Dental implants are now broadly used to replace missing teeth, and the presence of infectious complications is rising. Dental implant therapy as a local risk factor for the onset of osteomyelitis and its management have not been widely explored. Here, we report an unusual case of mandibular suppurative osteomyelitis caused by Streptococcus intermedius in a healthy and immunocompetent patient secondary to mandibular implants. We describe how surgery combined with systemic application of antibiotics allowed conservation of the dental implants in the mandibular bone, discuss the probable source of contamination, and present the follow-up of the osteomyelitis.
