Acute necrotizing ulcerative gingivitis associated with Stenotrophomonas Maltophilia, a case report
DOI:
https://doi.org/10.5327/2525-5711.20200033Keywords:
Dental care, Gingivitis, Necrotizing Ulcerative Stenotrophomonas maltophilia, Immunocompromised hostAbstract
The aim of this study was to report a case of Acute Necrotizing Ulcerative Gingivitis (ANUG) related to chemotherapy toxicity and infection by Stenotrophomonas maltophilia bacterium, until then only one case of ANUG associated with this bacterium has been described in the literature. Female patient, 20 years old, diagnosed with poorly differentiated neuroendocrine carcinoma, undetermined primary site, was treated with etoposide and cisplatin. She presented halitosis, desquamative necrotic gingival tissue, with pseudomembrane formation compatible with ANUG related to chemotherapy toxicity and infection by Stenotrophomonas maltophilia bacterium. The Standard Operational Protocol for Oral Care (Oral SOP) adapted by VIDAL, AKL (2012), with topical application of oral sodium bicarbonate solution, 0.12% chlorhexidine digluconate, and hydrogen peroxide 10 volumes diluted with water, presenting tissue recovery. Early diagnosis and appropriate treatment with a multiprofessional team are decisive measures in the prognosis of pathogen infection and in the patient’s quality of life.
References
Westphal GA, Pereira AB, Fachin SM, Barreto ACC, Bornschein ACGJ, Caldeira Filho M, et al. Características e desfechos de pacientes com sepse adquirida na comunidade e no hospital. Rev Bras Ter Intensiva. 2019 Jan/Mar;31(1):71-8.
Brooke JS. Stenotrophomonas maltophilia: an emerging global opportunistic pathogen. Clin Microbiol Rev. 2012 Jan;25(1):2-41.
Correia CR, Ferreira ST, Nunes P. Stenotrophomonas maltophilia: rare cause of meningitis. Pediatr Int. 2014 Aug;56(4):e21-2.
Gao Y, Minca EC, Procop GW, Begfeld WF. Stenotrophomonas maltophila cellulitis in an immunocompromised patient presenting with purpura, diagnosed on skin biopsy. J Cutan Pathol. 2016 Nov;43(11):1017-20.
Kagen J, Zaoutis TE, McGowan KL, Luan X, Shah SS. Bloodstream infection caused by Stenotrophomonas maltophilia in children. Pediatr Infect Dis J. 2007 Jun;26(6):508-12.
Calza L, Manfredi R, Chiodo F. Stenotrophomonas (Xanthomonas) maltophiliaas an emerging opportunistic pathogen in association with HIV infection: a 10-year surveillance study. Infection. 2003 Jun;31(3):155-61.
Nicodemo AC, Paez JIG.Antimicrobial therapy for Stenotrophomonas maltophilia infections. Eur J Clin Microbiol Infect Dis. 2007 Apr;26(4):229-37.
Murayama Y, Kurihara H, Nagai A, Dompkowski D, Van Dyke TE. Acute necrotizing ulcerative gingivitis: risk factors involving host defense mechanisms. Periodontol 2000. 1994 Oct;6:116-24.
Duft J, Gkranias N, Petrie A, McCormick R, Elmer T, Donos N. Prevalence and treatment of necrotizing ulcerative gingivitis (NUG) in the British Armed Forces: a case-control study. Clin Oral Investig. 2016 Jul;20(6):1935-44.
Herrera D, Alonso B, Arriba L, Cruz IS, Serrano C, Sanz M. Acute periodontal lesions. Periodontology 2000. 2014 Apr;65(1):149-77.
Niazi FH, Koppolu P, Tanvir SB, Samran A, Alqerban A. Clinical efficacy of photodynamic therapy in the treatment of necrotizing ulcerative periodontitis amongC HIV seropositive patients: a randomized controlled clinical trial. Photodiagnosis Photodyn Ther. 2020 Mar;29:101608.
Wakasaki T, Yasumatsu R, Masuda M, Matsuo M, Tamae A, Kubo K, et al. Small cell carcinoma in the head and neck. Ann Otol Rhinol Laryngol. 2019 Jun;128(1):1006-12.
Yu JJ, Hogan T, Morley C, Crigger C, Jiao S, Williams DJ, et al. Adverse effects profile of dicycloplatin (DCP) Offers chemotherapeutic advantage over cisplatin and carboplatin. Anticancer Res. 2019 Aug;39(8):4455-62.
Platistine® CS [Bula]. Bentley, Australia: Laboratórios Pfizer Ltda.; 2016.
Evoposdo® [Bula]. Montevidéu, Uruguai: Evolabis Produtos Farmacêuticos Ltda.; 2014.
Kato H, Imamura A. Unexpected acute necrotizing ulcerative gingivitis in a well-controlled HIV-infected case. Intern Med. 2017 Aug;56(16):2223-7.
Hu J, Kent P, Lennon JM, Logan LK. Acute necrotising ulcerative gingivitis in an immunocompromised young adult. BMJ Case Rep.
;2015:bcr2015211092. DOI: https://doi.org/10.1136/bcr-2015 211092
Vartivarian SE, Papadakis KA, Palacios JA, Manning JT, Anaissie EJ. Mucocutaneous and soft tissue infections caused by Xanthomonas maltophilia. Ann Intern Med. 1994;121:969-73.
Samonis G, Karageorgopoulos DE, Maraki S, Levis P, Dimopoulou D, Spernovasilis NA, et al. Stenotrophomonas maltophilia infections in a general hospital: patient characteristics, antimicrobial susceptibility, and treatment outcome. PloS One. 2012;7(5):e37375.
Sakhnini E, Weissmann A, Oren I. Fulminant Stenotrophomonas maltophilia soft tissue infection in immunocompromised patients: an outbreak transmitted via tap water. Am J Med Sci. 2002 May;323(5):269-72.
Moser C, Jonsson V, Thomsen K, Albrectsen J, Hansen MM, Prag J. Subcutaneous lesions and bacteraemia due to Stenotrophomonas maltophilia in three leulaemic patients with neutropenia. Br J Dermatol. 1997 Jun;136(6):949-52.
Soga Y, Saito T, Nishimura F, Ishimura F, Mineshiba J, Mineshiba F, et al. Appearance of multidrug-resistant opportunistic bacteria on the gingiva during leukemia treatment. J Periodontal. 2008 Jan;79(1):181-6.
Miyairi I, Franklin JA, Andreansky M, Knapp KM, Hayden RT. Acute necrotizing ulcerative gingivitis and bacteremia caused by Stenotrophomonas maltophilia in an immunocompromised host. Pediatr Infect Dis J. 2005 Feb;24(2):181-3.
Khardori N, Elting L, Wong E, Schable B, Bodey GP. Nosocomial infections due to Xanthomonas maltophilia (Pseudomonas maltophilia) in patients with cancer. Rev Infect Dis. 1990 Nov/ Dec;12(6):997-1003.
Vidal AKL. Importância da Odontologia para o paciente oncológico. In: Marques, CLTQ, Barreto CL, Morais VLL, Lima Júnior NF. Oncologia: uma abordagem multidisciplinar. Recife: Carpe Diem Edições e Produções Ltda.; 2015. p. 775-88.
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Copyright (c) 1969 Mayara Larissa Moura de Souza, Isabela Vicência Menezes Castelo-Branco, Laís Azevedo Lins de Holanda, Angelica Lopes Frade, Cristianne de Barros Santos, Virgínia Costa Moura, Leila Coutinho Taguchi, Aurora Karla de Lacerda Vida
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