title: Local presence of cytomegalovirus and Candida species vs oral lesions in liver and kidney transplant recipients.
abstract: BACKGROUND
  Anti-CMV prophylaxis is currently a routine management in patients after organ transplantation. One of the clinical symptoms of CMV infection may be lesions in the oral cavity.The aim of this study was to determine the relationship between CMV infection, occurrence of Candida species and presence of oral mucosal ulceration in transplant recipients.
  
  
  METHODS
  Twenty fi ve patients after kidney or liver transplantation (mean age 13 years +/-4 years), receiving immunosuppression (tacrolimus, cyclosporine or sirolimus), who presented minor and major recurrent aphtous stomatitis (RAS), atypical ulcerations or focal necrosis in the oral cavity were enrolled into the study. Mean duration of post-transplant follow-up was 4 years and 3 months (+/-3 years and 5 months). Clinical dental examination (Pl I, GI), mycological tests and blood tests for CMV infection (specific IgM antibodies and/or pp65 antygenemia) were performed in all patients. Eighteen specimens of oral mucosa were evaluated for CMV presence in situ.
  
  
  RESULTS
  CMV infection was confirmed in 13 patients with oral mucosal ulceration (46.43%); which were accompanied by gingivitis (average GI=1.34); in two cases Candida albicans was identified. DNA of HCMV was found in-situ in 5.5% of all biopsies, and in 9% of biopsies of patients with clinical CMV infection; changes did not show the presence of Candida spp.
  
  
  CONCLUSIONS
  There is a significant correlation between CMV infection and oral lesions; in some cases, CMV may be a direct cause.
authors.affiliation: Department of Oral Pathology, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Olczak-Kowalczyk
authors.forename: Joanna
authors.initials: J
authors.lastname: Pawłowska
authors.forename: Bozena
authors.initials: B
authors.lastname: Cukrowska
authors.forename: Przemysław
authors.initials: P
authors.lastname: Kluge
authors.forename: Ewa
authors.initials: E
authors.lastname: Witkowska-Vogtt
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Dzierzanowska-Fangrat
authors.forename: Danuta
authors.initials: D
authors.lastname: Wrześniewska
authors.forename: Ewa
authors.initials: E
authors.lastname: Smirska
authors.forename: Ryszard
authors.initials: R
authors.lastname: Grenda
mesh_terms: D000293:Adolescent; D002176:Candida albicans / Q000302:isolation & purification*; D002180:Candidiasis, Oral / Q000453:epidemiology*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D009061:Mouth Mucosa / Q000382:microbiology* / Q000821:virology; D019226:Oral Ulcer / Q000382:microbiology; D013280:Stomatitis / Q000453:epidemiology / Q000382:microbiology
chemical_list: D007166:Immunosuppressive Agents