title: Herpes simplex and cytomegalovirus coinfected oral ulcers in HIV-positive patients.
abstract: Four HIV-positive patients with herpes simplex virus and cytomegalovirus coinfected oral ulcers are presented. All patients had persistent oral pain associated with nonhealing mucosal ulcers. Lesions occurred on the palate, retromolar pad, tongue, and lip, and the clinical appearance of the ulcers was nonspecific. Histologic and immunohistochemical stains showed herpes simples virus alterations in keratinocyte nuclei and cytomegalovirus alterations in mesenchymal/endothelial cell nuclei and cytoplasm. Lesions in one patient responded to ganciclovir therapy. One patient improved with acyclovir, and another healed normally after excisional biopsy. Each virus alone has been described as causing oral ulcerations; their appearance together in the same lesion would suggest a synergistic relationship.
authors.affiliation: School of Dentistry, University of California San Francisco, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Regezi
authors.forename: L R
authors.initials: LR
authors.lastname: Eversole
authors.forename: B F
authors.initials: BF
authors.lastname: Barker
authors.forename: G M
authors.initials: GM
authors.lastname: Rick
authors.forename: S
authors.initials: S
authors.lastname: Silverman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000473:pathology*; D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002467:Cell Nucleus / Q000821:virology; D003587:Cytomegalovirus / Q000648:ultrastructure; D003586:Cytomegalovirus Infections / Q000473:pathology*; D003593:Cytoplasm / Q000821:virology; D004730:Endothelium, Vascular / Q000821:virology; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use; D005882:Gingival Diseases / Q000473:pathology / Q000821:virology; D006679:HIV Seropositivity / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D015603:Keratinocytes / Q000821:virology; D008047:Lip Diseases / Q000473:pathology / Q000821:virology; D008297:Male; D008648:Mesoderm / Q000821:virology; D008875:Middle Aged; D009059:Mouth Diseases / Q000473:pathology / Q000821:virology*; D010159:Palate; D018139:Simplexvirus / Q000648:ultrastructure; D013283:Stomatitis, Herpetic / Q000473:pathology*; D014060:Tongue Diseases / Q000473:pathology / Q000821:virology; D014456:Ulcer / Q000473:pathology / Q000821:virology
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir; D000212:Acyclovir