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Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report

Authors :
Julia Stephanie Bruno
Wanessa Miranda-Silva
Vitor Heidrich
Marianne de Castro Gonçalves
Yana Novis
Celso Arrais-Rodrigues
Anamaria Aranha Camargo
Eduardo Rodrigues Fregnani
Source :
BMC Oral Health, Vol 23, Iss 1, Pp 1-7 (2023)
Publication Year :
2023
Publisher :
BMC, 2023.

Abstract

Abstract Background Allogeneic hematopoietic stem cell transplant (allo-HSCT) is used to treat several hematological diseases, but immunosuppression during allo-HSCT facilitates opportunistic microbial growth in tissues, such as actinomycosis. An effective diagnosis of opportunistic diseases is essential for correct management of the disease and preservation of the immunosuppressed patient’s life. Case description A 57-year-old female patient was diagnosed with extranodal nasal type NK/T cell lymphoma and underwent curative treatment with allo-HSCT. Twenty-one days after the last clinical follow-up, the patient presented a necrotizing lesion in the papilla region between the first and second molars of the second quadrant. Histopathological analysis showed the presence of a bacterial cluster consistent with Actinomyces infection, and a dense lymphoid infiltrate was also observed. Immunohistochemistry for CD20, CD3, and CD56 was performed to exclude the possibility of the recurrence of extranodal NK/T cell lymphoma. Oral microbiota profiling showed a huge increase in the abundance of Actinomyces bacteria in the subgingival region three weeks prior to appearance of the lesion. Conclusions Opportunistic infections with an unusual clinical appearance are confounding factors in therapeutic decision-making. We present for the first time a case of actinomycosis in the gingival papilla region following allo-HSCT. We also highlight how microbiota profiling through next-generation sequencing could be used to anticipate bacterial infection diagnosis.

Details

Language :
English
ISSN :
14726831
Volume :
23
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Oral Health
Publication Type :
Academic Journal
Accession number :
edsdoj.8d70b2281fe64522a998ff4eae68d8b4
Document Type :
article
Full Text :
https://doi.org/10.1186/s12903-023-02777-7