ACTINOMYCOSIS: EARLY DIAGNOSIS IN THE POST ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION: CASE REPORT

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2020-01, Vol.129 (1), p.e64-e64
• Main Authors: DE ASSIS RAMOS, GABRIELA, VALENTIM, BÁRBARA BARRETO PACHECO, BRANDÃO, CAMILA LOBO, MOREIRA, MARIA CLAUDIA, PIRAGIBE, MARIA MIDORI MIURA, SILVA, TAÍSA DOMINGUES BERNARDES, ANTUNES, HÉLITON SPÍNDOLA
• Format: Article
• Language: English
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2019.06.245

A 28-year-old Brazilian man was diagnosed with chronic myeloid leukemia and submitted to allogeneic hematopoietic stem cell transplant. This patient presented on D+210 in the right side of oral cavity painful, shallow, and irregular ulcers on the palate, buccal mucosa, retromolar area, and palatal gingiva and increase of the upper gingival thickness with fibrous consistency and dark red areas with necrosis. Examination results were the following: red blood cells: 2.89 uL, platelets: 12 k/uL, neutrophils: 4366 uL, IgA < 50.0 mg/dL, and IgG 603 mg/dL. Because of the clinical characteristics, an exfoliative cytology was performed, and the patient started the use of oral acyclovir 2 g/d and chlorhexidine  0.12% mouthwash. One day later the cytologic examination result suggested herpes virus, Actinomyces spp, and Candida spp. On the D+214, the patient was admitted to the hospital and treated with ampicillin/intravenously (IV)/8 g/d/21 days + acyclovir/IV 2 g/d/21 days + voriconazole/IV/400 mg/d/21 days. After hospital release, the patient continued treatment using amoxicillin 3 g/d/28 days, and at the end of the medication he was stable.