Cases reported "Gingival Diseases"

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1/8. histoplasmosis of the gingiva. Report of a case.

    A 71-year-old white man presented with a large ulcerated lesion which extended to the facial and palatal aspects of the maxillary left first and second bicuspids. A biopsy was made because the lesion appeared to be carcinomatous. It proved to be benign but it was positive for histoplasmosis. Although the patient had a 9 month history of weight loss, fatigue, frequent nausea, night sweats, respiratory symptoms, and other symptoms compatible with a diagnosis of histoplasmosis, skin tests and complement fixation tests had been consistently negative. After the diagnosis was made and the organism was cultured from the oral lesion, therapy (amphotericin b) was initiated and the patient responded favorably. Within 12 months, the symptoms regressed, the oral lesions healed, and the patient regained 25 lb.
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2/8. Pneumococcal bacteremia associated with gingival lesions in infants.

    Five infants with fever, leukocytosis, and a cystic lesion superimposed on a swollen gingiva had pneumococcal bacteremia. Lesions were so characteristic that a presumptive diagnosis of pneumococcal bacteremia was made in the last three patients before confirmation by blood cultures. Infants who initially have these symptoms should be considered at risk for pneumococcal bacteremia.
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3/8. Oral geotrichum candidum infection associated with hiv infection. A case report.

    Infections with geotrichum species, although rare, are sometimes seen in immunocompromised hosts. We report a case of oral geotrichosis in a patient seropositive for human immunodeficiency virus who had erythematous mandibular and maxillary gingiva but was otherwise free of any active systemic disease. geotrichum candidum was shown by both culture and histopathology to be present in the lesion and was deduced to be the causative organism. The patient responded well to several weeks of treatment involving oral topical administration of nystatin vaginal tablets.
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4/8. Mucocutaneous leishmaniasis in a US citizen.

    Mucocutaneous leishmaniasis (MCL) is endemic to many areas of Central and south america. A case of MCL in a US citizen is reported here. An ulcer appeared on the patient's left hard palate, years after a working trip to peru. Punch biopsies of the lesion were obtained, Leishmania promastigotes were isolated by culture and animal inoculation, and the patient was appropriately treated. As this case demonstrates, a patient's travel history is a key element in making a differential diagnosis of oral lesions.
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5/8. Rapidly progressive acute periodontal infection in a patient with acute leukemia.

    The clinical course of an adult patient with acute lymphocytic leukemia and localized, rapidly progressive periodontal disease in a setting of marrow regeneration is described. Initial presentation of this condition was consistent with herpes simplex virus infection involving the gingiva; however, more extensive evaluation including radiographs, cultures and biopsy revealed necrotic tissue, nonspecific bacterial growth and acute gingival inflammation, with no evidence of viral infection. While most acute oral infections in chemotherapy patients occur during the development of marrow aplasia, this lesion initially developed late during the marrow recovery phase. The characteristics of this lesion are compared with those occurring in noncancer patients with rapidly progressive periodontitis and who have genetically governed neutrophil and/or lymphocyte defects.
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6/8. Oral histoplasmosis treated with miconazole.

    A case of localised histoplasmosis of the gingivae, with no osseous involvement is described in a 50-year-old man. The diagnosis was based on histology, growth on culture and a positive histoplasmin latex test. Therapy was commenced with intravenous amphotericin but was changed to intravenous miconazole because of serious immediate side effects and the development of marked renal impairment and moderate suppression of erythropoiesis. Rebiopsy of the gingival margin showed therapy to be effective. No source of the infection could be traced.
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7/8. Oral fusarium infection in a granulocytopenic patient with acute myelogenous leukemia: a case report.

    The fungus fusarium moniliforme causes fusariosis, which can be invasive and fatal in immunocompromised patients. We report a case of oral fusarium infection in a granulocytopenic patient with acute myelogenous leukemia who developed necrotic ulceration of the gingiva, extending to the alveolar bone, but was otherwise free of any active systemic lesions. fusarium moniliforme was identified, by histopathology and culture, to be present in the lesion and was deduced to be the causative organism for this invasive oral infection.
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8/8. Localised oral histoplasmosis lesions associated with hiv infection.

    Opportunistic fungal infections account for a significant amount of morbidity associated with hiv disease. We report here a case of localised oral histoplasmosis without evidence of disseminated disease in a patient who lacked stigmata of hiv disease at the time of initial presentation. The diagnosis is based on histology with special stains, complement fixing antibodies in serum, and culture of the organism from fresh tissues. Activation of subclinical disease following an infection in uganda may explain the development of these exophytic oral lesions in this British resident.
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