Blastomyces in pathological lesions on oral mucous membrane in children and adolescents after transplant and with kidney or liver diseases
Journal Title: Journal of Stomatology (Czasopismo Stomatologiczne) - Year 2012, Vol 65, Issue 5
Abstract
Introduction. Kidney or liver diseases and immunosuppressive therapy favour the occurrence of pathological lesions on the oral mucosa, frequently of mixed etiology. Blastomyces may act as co-pathogens. Due to the frequency of infections, drug-resistance of fungi and the risk of infection spread in cases of immunodeficiency, it is crucial to recognize the lesion type on the oral mucosa, frequency of candida infections, and their predisposing factors. Aim of the study. An assessment of pathological lesion type on the oral mucosa in patients with kidney and liver diseases, in recipients of those organs, the participation of blastomyces in the lesions and the impact of immunosuppressive drugs. Material and methods. 102 patients (aged 12.7 ± 5.3 years) with lesions on the oral mucosa (12 – nephritic syndrome, 20 – chronic liver diseases, 38 – kidney recipients, 32 – liver recipients), including 87 after immunosuppressive therapy, were subjected to clinical and mycological examinations. The results were analyzed statistically. Results. The following lesions were observed: erythema, pseudomembranous deposits, angular cheilitis, RAS minor, ulcerations, lichenoid lesions, herpes, leukoplakia, black, geographical and bald tongue, cheilitis. 38.2% of patients demonstrated >1 types of lesions, which was favoured by administration of >1 immunosuppressive drugs, kidney transplant, CsA. Mycophenolate mofetil predisposed to ulcerations, CsA to candidiasis. Candida spp. was observed in 48.6% of patients with lesions suggesting candidiasis, and in 20.4% of patients without candidiasis, where the colony size was considerably smaller. Conclusions. Multi-drug immunosuppression and kidney transplant favour the co-occurrence of various lesions on mucous membrane, including candidiasis; individual drugs may predispose to development of particular lesion type. In immunodeficiency, mycological examination is necessary in diagnostics of lesions on mucous membrane.
Authors and Affiliations
Dorota Olczak-Kowalczyk, Dariusz Gozdowski, Ryszard Grenda, Joanna Pawłowska, Renata Górska
Keywords
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