acyclovir and Mouth-Diseases

Topics: Acyclovir; Aged; Amphotericin B; Antifungal Agents; Antiviral Agents; Aspergillosis; Fatal Outcome; Humans; Immunocompromised Host; Leukemia, Myeloid, Acute; Male; Mouth Diseases; Paranasal Sinus Diseases; Pyrimidines; Triazoles; Voriconazole

Viral lesions of the mouth in patients with HIV infection are common and these diseases any be a marker for HIV and disease progression. We review the spectrum of oral viral manifestations and discuss treatment modalities. The most common Epstein-Barr virus (EBV)-induced disorder in HIV-infected patients is oral hairy leukoplakia. EBV-related oral B-cell and T-cell lymphoma in AIDS patients has been described repeatedly. Herpes virus type 1 and rarely type 2 may lead to painful and resistant oral ulcers, and systemic treatment with acyclovir, valaciclovir or famciclovir is indicated. In acyclovir-resistant cases foscarnet is the treatment of choice. In recent years it has been documented that Kaposi's sarcoma, which often affects oral mucosa, is probably induced by herpesvirus type 8. Cytomegalovirus was found in 53% of cases with herpesviridae-induced mucosal ulcers as the only ulcerogenic viral agent in AIDS patients. In severe cytomegalovirus infection treatment with ganciclovir is helpful. Viral warts induced by different HPV may occur in the mouth. Several physical treatment modalities are possible in the oral mucosa. In AIDS patients mollusca contagiosa may occur as large and atypical lesions in the face and lips and rarely in the oral cavity. Cryotherapy is a bloodless treatment in such patients.

Topics: 2-Aminopurine; Acyclovir; AIDS-Related Opportunistic Infections; Anti-HIV Agents; Cytomegalovirus Infections; Disease Progression; Famciclovir; Foscarnet; Ganciclovir; Herpesviridae Infections; Herpesvirus 1, Human; Herpesvirus 2, Human; Herpesvirus 4, Human; Herpesvirus 8, Human; Humans; Leukoplakia, Hairy; Lymphoma, B-Cell; Lymphoma, T-Cell; Molluscum Contagiosum; Mouth Diseases; Mouth Neoplasms; Oral Ulcer; Prodrugs; Sarcoma, Kaposi; Stomatitis, Herpetic; Tumor Virus Infections; Valacyclovir; Valine; Virus Diseases; Warts

Topics: Acyclovir; Herpes Labialis; Herpes Zoster; Herpesviridae Infections; HIV Infections; Humans; Mouth Diseases; Stomatitis, Herpetic; Virus Diseases

Neonatal herpes simplex virus (HSV) infections limited to the skin, eyes and mouth (SEM) can result in neurologic impairment. A direct correlation exists between the development of neurologic deficits and the frequency of cutaneous HSV recurrences. Thus, the National Institutes of Allergy and Infectious Diseases Collaborative Antiviral Study Group conducted a Phase I/II trial of oral acyclovir therapy for the suppression of cutaneous recurrences after SEM disease in 26 neonates.. Infants < or = 1 month of age with virologically confirmed HSV-2 SEM disease were eligible for enrollment. Suppressive oral acyclovir therapy (300 mg/m2/dose given either twice daily or three times per day) was administered for 6 months.. Twelve (46%) of the 26 infants developed neutropenia (< 1000 cells/mm3) while receiving acyclovir. Thirteen (81%) of the 16 infants who received drug 3 times per day experienced no recurrences of skin lesions while receiving therapy. In comparison, a previous Collaborative Antiviral Study Group study found that only 54% of infants have no cutaneous recurrences in the 6 months after resolution of neonatal HSV disease if oral acyclovir suppressive therapy is not initiated. In one infant, HSV DNA was detected in the cerebrospinal fluid during a cutaneous recurrence, and an acyclovir-resistant HSV mutant was isolated from another patient during the course of the study.. Administration of oral acyclovir can prevent cutaneous recurrences of HSV after neonatal SEM disease. The effect of such therapy on neurologic outcome must be assessed in a larger, Phase III study. As such, additional investigation is necessary before routine use of suppressive therapy in this population can be recommended.

Topics: Acyclovir; Administration, Oral; Antiviral Agents; Drug Resistance; Eye Infections, Viral; Female; Herpes Genitalis; Herpesvirus 2, Human; Humans; Infant, Newborn; Male; Mouth Diseases; Recurrence; Retrospective Studies; Skin Diseases, Viral

To evaluate (a) the prophylactic effect of the antiherpetic drug acyclovir on oral ulcers in patients with acute myeloid leukaemia receiving remission induction chemotherapy and thus (b), indirectly, the role of herpes simplex virus in the aetiology of these ulcers.. Randomised, double blind, placebo controlled trial.. 74 herpes simplex virus seropositive patients aged 18-84. Thirty seven patients received acyclovir (800 mg by mouth daily) and 37 placebo. The patients were examined daily for 28 days.. Occurrence of herpes labialis, intraoral ulcers, and acute necrotising ulcerative gingivitis.. The two populations were comparable in age, sex, type of antineoplastic treatment, and history of herpes labialis. Acute oral infections occurred in 25 of the acyclovir treated patients and 36 of the placebo treated patients (relative risk 0.69 (95% confidence interval 0.55 to 0.87)). This difference was due to a reduction in the incidence of herpes labialis (one case versus eight cases; relative risk 0.13 (0.02 to 0.95)), intraoral ulcers excluding the soft palate (one case versus 13 cases; relative risk 0.08 (0.01 to 0.56)), and acute necrotising ulcerative gingivitis (one case versus eight cases; relative risk 0.13 (0.02 to 0.95)). However, ulcers on the soft palate were diagnosed with similar frequency in the two groups. Isolation of herpes simplex virus type 1 in saliva was reduced from 15 cases in the placebo group to one case in the acyclovir group (relative risk 0.07 (0.01 to 0.48)).. Intraoral ulcers excluding the soft palate are most often due to infection with herpes simplex virus, whereas ulcers on the soft palate have a non-herpetic aetiology. The findings suggest that acute necrotising ulcerative gingivitis may also be due to herpes simplex virus. Prophylaxis with acyclovir should be considered for patients with acute myeloid leukaemia during remission induction therapy.

Topics: Acute Disease; Acyclovir; Adolescent; Adult; Aged; Aged, 80 and over; Double-Blind Method; Female; Gingivitis, Necrotizing Ulcerative; Herpes Labialis; Herpes Simplex; Humans; Leukemia, Myeloid; Male; Middle Aged; Mouth Diseases; Opportunistic Infections; Stomatitis, Herpetic; Ulcer

In comparison to the range of antibiotics used in medicine, the spectrum of antifungal and antiviral drugs used in primary dental care is relatively limited. In practical terms, there are only three antifungal agents and two antiviral agents that have a role. This paper will describe the clinical presentation of orofacial candidal and viral infections and the use of antimicrobial drugs in their management.

Topics: Acyclovir; Amphotericin B; Antifungal Agents; Antiviral Agents; Candidiasis, Oral; Cheilitis; Dental Care; Fluconazole; Glossitis; Guanine; Herpes Zoster; Humans; Miconazole; Mouth Diseases; Nystatin; Primary Health Care; Stomatitis, Herpetic

Solid organ transplantation no longer is considered a rare procedure. After undergoing transplants, patients will require both routine and emergent oral health care, and it can be provided safely in private dental offices. Transplant recipients are immunosuppressed, and for this reason clinicians should be alert for oral abnormalities in such patients.. A 53-year-old man with a history of cardiac transplant and multiple medical comorbidities had unusual mucosal plaques, oral discomfort and skin lesions. As a result of his compromised immune system, the clinical presentation of his condition-which proved to be herpes zoster (HZ) virus, also called "shingles"-was atypical, resulting in a delay of the definitive diagnosis.. and. HZ is a serious infection in the immunocompromised population. Timely diagnosis and treatment of this condition is necessary to prevent treatment delay and medication errors.

Topics: Acyclovir; Antiviral Agents; Heart Transplantation; Herpes Zoster; Humans; Immunocompromised Host; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Skin

Topics: Acyclovir; Adrenal Cortex Hormones; Antiviral Agents; Herpesviridae Infections; Humans; Immunocompromised Host; Male; Middle Aged; Mouth Diseases; Pemphigus

Erythema multiforme is an acute mucocutaneous disorder, characterized by varying degrees of blistering and ulceration. We report a case of recurrent herpes-associated erythema multiforme managed with prophylactic acyclovir. An 11-year-old boy had lesions in the oral cavity and lips, which had been diagnosed as erythema multiforme minor. Four months later, the patient had desquamative gingivitis with erythematous lesions and necrotic areas in the skin. This episode was not related to drug intake, which suggests that the erythema multiforme was a result of herpetic infection. This hypothesis was supported by positive serology for herpes simplex virus. Five months later, the patient returned with new oral, skin and penis mucosal lesions. The diagnosis was confirmed as herpes simplex virus-associated erythema multiforme major. The episode was treated with acyclovir, and acyclovir was used prophylactically for 7 months to control the disease.

Topics: Acyclovir; Antiviral Agents; Child; Erythema Multiforme; Follow-Up Studies; Gingivitis; Herpes Genitalis; Herpes Labialis; Humans; Lip Diseases; Male; Mouth Diseases; Penile Diseases; Recurrence; Simplexvirus; Stomatitis, Herpetic

This is the fourth paper in a series on the prescribing of medicines for children by dentists working in primary dental care. It deals with the prescription of antifungals and antivirals for children.

Topics: Acyclovir; Antifungal Agents; Antiviral Agents; Azoles; Candidiasis, Oral; Child; Drug Prescriptions; Humans; Infant; Infant, Newborn; Mouth Diseases; Polyenes; Stomatitis, Herpetic

Ramsay-Hunt syndrome (RHS) usually affects adults, but rare cases of preschool children with RHS have been reported. We report a case of RHS in a healthy 4-year-old girl. At the age of 4 years and 5 months, she complained of pain in her mouth and herpes zoster vesicles were noted on the left soft palate and tongue without left pinna, and complete left facial paralysis subsequently developed. She was treated with acyclovir and steroids. Six months later, her facial paralysis had almost fully resolved.

Topics: Acyclovir; Anti-Inflammatory Agents; Antiviral Agents; Child, Preschool; Drug Combinations; Facial Paralysis; Female; Herpes Zoster Oticus; Humans; Mouth Diseases; Prednisolone; Syndrome

Topics: Acyclovir; Adolescent; Adult; Antiviral Agents; Bone Marrow Transplantation; Child; Drug Resistance, Microbial; Female; Graft vs Host Disease; Herpes Simplex; Humans; Leukemia; Male; Mouth Diseases; Opportunistic Infections

Persistent mucocutaneous ulcers in AIDS represent a variety of disease entities. The purpose of this study was to characterize clinicopathologic features of persistent oral ulcers associated with cytomegalovirus and herpes simplex virus in AIDS. Forty-seven persons infected with HIV with persistent ulcers (mean, 2.4 ulcers/person) were included in this study. A biopsy specimen from a representative ulcer was taken from each patient. Hematoxylin-eosin, periodic acid-Schiff, cytomegalovirus, and herpes simplex virus immunocytochemical stains were performed on tissue sections. The most common sites of involvement were the buccal/labial mucosa (27%), tongue (25%), and gingiva (18%). Mean ulcer size was 1.8 cm with a mean duration of 5.6 weeks. The ulcerogenic viral agents were cytomegalovirus alone in 53% of cases, cytomegalovirus and herpes simplex virus coinfection in 28% of cases, and herpes simplex virus alone in 19% of cases. Treatment response to ganciclovir with or without topical steroids resulted in lesion resolution in the cytomegalovirus and cytomegalovirus/herpes simplex virus groups; however, recurrence/resistance was relatively high (23%). Herpes simplex virus/cytomegalovirus ulcers responded to oral acyclovir in combination with systemic ganciclovir. Increasing the oral acyclovir dosage resulted in resolution of herpes simplex virus-only ulcers in all but one case. Cytomegalovirus and herpes simplex virus are associated with persistent mucocutaneous ulcers in AIDS. These lesions responded to systemic antiviral therapy but are difficult to differentiate from other ulcerogenic diseases such as aphthous major, necrotizing stomatitis, and ulcerations not otherwise specified without biopsy and histopathologic examination.

Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Cytomegalovirus Infections; Cytopathogenic Effect, Viral; Diagnosis, Differential; Female; Ganciclovir; Humans; Male; Middle Aged; Mouth Diseases; Recurrence; Stomatitis, Herpetic; Ulcer

Four HIV-positive patients with herpes simplex virus and cytomegalovirus coinfected oral ulcers are presented. All patients had persistent oral pain associated with nonhealing mucosal ulcers. Lesions occurred on the palate, retromolar pad, tongue, and lip, and the clinical appearance of the ulcers was nonspecific. Histologic and immunohistochemical stains showed herpes simples virus alterations in keratinocyte nuclei and cytomegalovirus alterations in mesenchymal/endothelial cell nuclei and cytoplasm. Lesions in one patient responded to ganciclovir therapy. One patient improved with acyclovir, and another healed normally after excisional biopsy. Each virus alone has been described as causing oral ulcerations; their appearance together in the same lesion would suggest a synergistic relationship.

Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antiviral Agents; Cell Nucleus; Cytomegalovirus; Cytomegalovirus Infections; Cytoplasm; Endothelium, Vascular; Follow-Up Studies; Ganciclovir; Gingival Diseases; HIV Seropositivity; Humans; Immunohistochemistry; Keratinocytes; Lip Diseases; Male; Mesoderm; Middle Aged; Mouth Diseases; Palate; Simplexvirus; Stomatitis, Herpetic; Tongue Diseases; Ulcer

Oral manifestations of herpes zoster are very less common than cutaneous. Only a few cases of oral herpes zoster in children had been already described. Authors report a case of maxillary superior nerve's herpes zoster. Oral lesions are encountered in case of viral disease of the second and third branch of trigeminal nerve (VII, VIII). Dental pain is usually the first sign and can induce misdiagnosis. The diagnosis is based on the specific ulcerative lesions, strictly unilateral, developed in the field of sensitive innervation of the maxillary nerves. The use of antiviral drugs seems to be actually the best treatment.

Topics: Acyclovir; Child; Cranial Nerve Diseases; Female; Herpes Zoster; Humans; Maxillary Nerve; Mouth Diseases; Pain

Few longitudinal studies have investigated the onset, duration, and resolution of ulcerative mucositis in bone marrow transplant recipients. This study prospectively followed a group of such patients on a daily basis to obtain data on the incidence of ulcerative mucositis, location and duration of lesions, severity with different conditioning regimens, and the relationship of such mucositis to the absolute neutrophil count.. Fifty-nine bone marrow transplant recipients on prophylactic acyclovir were examined daily for 26 days after marrow infusion, and all oral ulcerative lesions were recorded.. Oral ulcers occurred in 76.3% of patients, began at a mean of 5 days after marrow infusion (day + 5), and lasted for a median of 6 days. More than 90% of patients showed complete resolution of ulcers on or before day + 15, and all showed resolution when the absolute neutrophil count was > 500 cells/ml. Persistence of ulcers was noticed in patients who had oral graft-versus-host disease and in some patients who initially developed more severe ulcerations. Ninety-six percent of ulcers were located on nonkeratinized mucosa.. Ulcerative mucositis occurs in about 75% of bone marrow transplant recipients in the absence of herpes simplex virus infection. Most lesions occur on nonkeratinized mucosae which are vulnerable to trauma, especially if such mucosae are rendered atrophic by conditioning regimens. Oral ulcers may persist beyond day + 15 and after recovery of the neutrophil count in patients who initially develop more severe ulcerations or in patients who develop graft-versus-host disease.

Topics: Acyclovir; Adolescent; Adult; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Bone Marrow Transplantation; Candidiasis, Oral; Child; Cohort Studies; Diagnosis, Differential; Female; Graft vs Host Disease; Humans; Incidence; Longitudinal Studies; Male; Middle Aged; Mouth Diseases; Prospective Studies; Stomatitis; Time Factors; Ulcer

Recurrent oral herpes simplex virus lesions are common in both immunocompetent and immunocompromised persons. In contrast, cytomegalovirus-associated intraoral lesions are rarely seen, even in the immunocompromised host. We report a case of concurrent oral herpes simplex virus and cytomegalovirus infection, appearing as an ulcerative lesion of the labial mucosa in a patient with acquired immunodeficiency syndrome. Herpes simplex virus type 1 was shown to be present in the lesion by culture tests, histopathologic examination, immunohistochemistry findings and a direct immunofluorescence assay, and cytomegalovirus by histopathologic examination and immunohistochemistry findings. We deduce that the lesion was due to concurrent herpes simplex virus-1 and cytomegalovirus infection. The patient responded well to 2 weeks of treatment with a high dose of acyclovir.

Topics: Acyclovir; Adult; AIDS-Related Opportunistic Infections; Antibodies, Monoclonal; Cytomegalovirus; Cytomegalovirus Infections; Humans; Lip Diseases; Male; Mouth Diseases; Mouth Mucosa; Simplexvirus; Stomatitis, Aphthous; Stomatitis, Herpetic; Superinfection

Topics: Acyclovir; Herpes Zoster; Humans; Mouth Diseases; Stomatitis, Herpetic

Topics: Acyclovir; Amphotericin B; Anti-Bacterial Agents; Bacterial Infections; Herpes Labialis; Humans; Mouth Diseases; Mycoses; Neoplasms

Topics: Acyclovir; Dentists; Herpesviridae Infections; Humans; Interferons; Mouth Diseases; Occupational Diseases

Topics: Acyclovir; Herpes Simplex; Herpes Zoster; Humans; Mouth Diseases; Stomatitis, Herpetic; Virus Diseases; Warts