title: Intercurrent infectious diseases in post-stem cell transplant patients:  paranasal sinusitis.
abstract: Improvements in treatments available for oncohematologic diseases have made it possible to treat patients at more advanced stages of the disease and thus at greater risk of fungal, bacterial, and viral infections; these may be extensive and have aggressive evolution. In particular, chemotherapy at high doses and allogenic bone marrow transplant expose patients to an increased risk of infection, especially because of the period of aplasia and the condition of immune depression subsequent to the procedure. We presented a case of a 15-year-old adolescent girl diagnosed with combined relapse of acute lymphoblastic leukemia 2 years after completion of first-line chemotherapy that, at 120 days after transplant, erosive lesions of the palatal mucosa at the left hemipalate in the area adjacent to tooth 2.7 were detected, of approximately 2 mm in size. These gave rise to an orosinus communication. Various therapeutic possibilities are examined. These cases are not frequent. Diseases and their related complications require an in-depth knowledge, on the part of the stomatologist, to recognize the early signs of involvement of the oral cavity and, on the part of the oral surgeon, to decide the most appropriate therapeutic strategy.
authors.affiliation: Department of Medical Science, Faculty of Medicine, University of Eastern Piedmont, Novara, Italy. carmenmortellaro@hotmail.com
authors.forename: Carmen
authors.initials: C
authors.lastname: Mortellaro
authors.forename: Veronica
authors.initials: V
authors.lastname: Barat
authors.forename: Francesca
authors.initials: F
authors.lastname: Nesi
authors.forename: Lucilla
authors.initials: L
authors.lastname: Bello
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bologna
authors.forename: Davide
authors.initials: D
authors.lastname: Farronato
authors.forename: Alberta Greco
authors.initials: AG
authors.lastname: Lucchina
authors.forename: Alessandra
authors.initials: A
authors.lastname: Linari
mesh_terms: D000293:Adolescent; D003587:Cytomegalovirus / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000175:diagnosis; D016984:Enterococcus faecium / Q000502:physiology; D017809:Fatal Outcome; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015523:Maxillary Sinusitis / Q000382:microbiology*; D009957:Oroantral Fistula / Q000382:microbiology*; D010158:Palatal Obturators; D011183:Postoperative Complications; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000601:surgery; D011552:Pseudomonas Infections / Q000175:diagnosis*; D019172:Transplantation Conditioning / Q000379:methods; D014775:Virus Activation / Q000502:physiology