Bottone EJ, Lee PG; American Society for Microbiology. General Meeting.
Abstr Gen Meet Am Soc Microbiol. 1996 May 19-23; 72 (abstract no. C-403).
Division of Infectious Diseases, The Mount Sinai Medical Center, New York, NY.
Oral lesions are commonly associated with HIV infection and may have an infectious neoplastic or idiopathic etiology. While fusobacteria and spirochetes comprise part of the normal mouth flora, their overgrowth can lead to severe and acute neurotizing ulcerative gingivitis (ANUG) as a primary disease or complicate the course of pre-existing oral mucosal lesions. Through microbiologic consultation, three patients were encountered with exquisitely painful non-bleeding oral lesions overlaid with a grayish-black semi-adherent membrane. Sites of involvement included left cheek,palate, and right molar gum line; underlying conditions included CMV infection (2) and irradiated Kaposi's sarcoma. Biopsy of the palatal lesion was initially interpreted as containing fungal elements. Gram-stained smears of teased membranes, however, showed an impressive array of microbial species with numerous fusiforms and spirochetes embedded in the microbial matrix. Treatment with penicillin brought amelioration of painful symptoms within 48h with concomitant sloughing of the membrane. Fusospirochetal involvement of oral lesion should be suspected when patients present with pronounced pain and fetid breath. Diagnosis may be achieved by evaluation of Gram-stained smears.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Gingivitis, Necrotizing Ulcerative
- HIV Infections
- Humans
- Mouth Diseases
- Mouth Mucosa
- Palate
- Sarcoma, Kaposi
- Spirochaetales Infections
- Superinfection
Other ID:
UI: 102222973
From Meeting Abstracts