Policar M, Bottone EJ; IAS Conference on HIV Pathogenesis and Treatment (2nd : 2003 : Paris, France).
Antivir Ther. 2003; 8 (Suppl.1): abstract no. 913.
Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, USA
OBJECTIVE: To describe a previously unrecognized oral manifestation of HIV infection. METHOD: Microscopic and gross evaluation of a recurrent, adherent, white membranous coating enveloping the tongue of a patient with AIDS. The patient complained of a decreased sensation of taste, but denied pain, odynophagia, fever or foul odour. The coating was easily peeled off the tongue, but quickly recurred. There was no response to treatment with a variety of antifungal agents for presumed oral candidiasis. RESULTS: On gross examination, membranous fragments were thick, white and elastic. Giemsa and Gram staining revealed enormous numbers of bacterial organisms surrounded by a clear amorphous acellular substance without evidence of fungal elements, herpesvirus inclusions or inflammatory infiltrates. Some areas were adherent to hyperplastic superficial squamous epithelium. Histological examination of tongue fragments revealed innumerable discrete and random accretions of bacterial aggregates (colonies) interwoven into the tongue epithelium. Also present in linear arrangements were bundles of Leptothrix bacilli, also clearly discerned on GMS stain, and erroneously described as fungal elements. CONCLUSION: Lingual bacteriosis, a newly recognized manifestation of HIV infection, should be considered in the differential diagnosis of thrush, especially when there is no response to antifungal therapy. Treatment with 14 days of amoxicillin/clavulinate and mechanical debridement resulted in resolution of this condition, without recurrence up to 4 months follow-up.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antifungal Agents
- Candidiasis, Oral
- HIV Infections
- Humans
- Taste
- Tongue
- Tongue Diseases
- therapy
Other ID:
UI: 102263191
From Meeting Abstracts