Local presence of cytomegalovirus and Candida species vs oral lesions in liver and kidney transplant recipients.
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.
Olczak-Kowalczyk
Dorota
D
Department of Oral Pathology, The Children's Memorial Health Institute, Warsaw, Poland.
Pawłowska
Joanna
J
Cukrowska
Bozena
B
Kluge
Przemysław
P
Witkowska-Vogtt
Ewa
E
Dzierzanowska-Fangrat
Katarzyna
K
Wrześniewska
Danuta
D
Smirska
Ewa
E
Grenda
Ryszard
R
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
D007166:Immunosuppressive Agents