Rapid progression of bone loss in HIV-associated necrotizing ulcerative stomatitis.
This report describes a case of rapidly progressive periodontal tissue breakdown and bone loss in an HIV-infected markedly immunosuppressed homosexual male. Within 6 months of initial presentation with a necrotizing ulcerative gingivitis, the lesion extended to a necrotizing ulcerative stomatitis involving the surrounding periodontium and palatal mucosa. With only partial compliance to local debridement, chlorhexidine oral rinses, and systemic metronidazole therapy, alveolar bone loss resulted in tooth mobility necessitating extraction of 2 involved teeth. This case illustrates the continuum of necrotizing ulcerative infections of the periodontium in the severely immunosuppressed patient. The implications of these oral manifestations of HIV infection are discussed.
Patton
L L
LL
Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA. Lauren_Patton@dentistry.UNC.EDU
McKaig
R
R
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000328:Adult; D016301:Alveolar Bone Loss / Q000473:pathology*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use; D003646:Debridement; D018450:Disease Progression; D005892:Gingivitis, Necrotizing Ulcerative / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D009061:Mouth Mucosa / Q000473:pathology; D009067:Mouthwashes / Q000627:therapeutic use; D010159:Palate; D014081:Tooth Extraction; D014086:Tooth Mobility / Q000209:etiology
D000890:Anti-Infective Agents; D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D008795:Metronidazole; D002710:Chlorhexidine