amphotericin-b and Mouth-Neoplasms

Primary mucosal leishmaniasis is a rare infectious disease, particularly in immunocompetent patients. We present a 50-year-old patient with a 6-week history of a painful lesion of the left buccal mucosa that mimicked cancer. The exophytic lesion looked invasive, and we took an incisional biopsy specimen to exclude cancer. The diagnosis of leishmaniasis was unexpected, and the patient was successfully treated with amphotericin B for five weeks. After five months the patient had a visceral recurrence. Chronic exophytic and ulcerated mucosal lesions that do not heal within 3-4 weeks should be regarded as the first signs of oral cancer, but primary oral leishmaniasis can easily mimic it.

Topics: Amphotericin B; Antiprotozoal Agents; Diagnosis, Differential; Follow-Up Studies; Humans; Leishmaniasis, Mucocutaneous; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Recurrence

The term leishmaniasis comprises a group of diseases caused by different protozoan species of the genus Leishmania. There are three main clinical forms of leishmaniasis: visceral, cutaneous and mucocutaneous. Exclusive involvement of the mucosa is very rare.. To present a case of mucocutaneous leishmaniasis in an elderly patient, discuss the clinical presentation, diagnostic process and treatment emphasizing the distinctions from other granulomatous lesions.. A 71-year-old male presenting with a symptomatic lesion on the hard and soft palate, which had developed over a period of 6 months was evaluated. The oral exam revealed a lesion with multiple ulcerated nodules on the hard and soft palate extending to the oropharynx. The diagnostic hypothesis was chronic infectious disease (paracoccidioidomycose, tuberculosis and leishmaniasis) or squamous cell carcinoma. Histopathological, histochemical and immunohistochemical analysis were performed. A chest x-ray revealed a normal pulmonary pattern. The Montenegro skin test was positive. The definitive diagnosis was leishmaniasis with exclusive oral manifestation and the patient was treated with liposomal amphotericin.. Localized oral mucosa leishmaniasis is an uncommon event in an immunocompetent patient. Dentists play an important role in the diagnosis of oral leishmaniasis, which has systemic repercussions.

Topics: Aged; Amphotericin B; Antiprotozoal Agents; Carcinoma, Squamous Cell; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Leishmaniasis; Male; Mouth Diseases; Mouth Neoplasms; Oral Ulcer; Palate, Hard; Palate, Soft; Paracoccidioidomycosis; Tuberculosis, Oral

Aspiration of oropharyngeal bacteria and fungi is occasionally suspected in patients with pneumonia. A patient with oral carcinoma underwent chemoradioimmunotherapy and, about 4 weeks from the start of the therapy, the patient suffered from severe oral mucositis induced by chemoradiotherapy, and candidal pneumonia was subsequently induced. The candidal pneumonia was insufficiently improved by potent antifungal drugs, taking a lethal course. Randomly amplified polymorphic DNA analysis and DNA sequence examination of strains isolated from the oral cavity 1 week before the onset of pneumonia and autopsied lung revealed the identity of both strains as Candida albicans, and the DNA analysis supported aspiration of oral Candida. These results indicate that the pathogen of the pneumonia, C. albicans, was aspirated from the oral cavity and that oral Candida is easily aspirated and becomes the pathogen of pneumonia.

Topics: Aerosols; Aged; Aged, 80 and over; Amphotericin B; Antifungal Agents; Antineoplastic Agents; Base Sequence; Candida albicans; Candidiasis; Candidiasis, Oral; Carcinoma, Squamous Cell; DNA, Fungal; Fatal Outcome; Female; Fluconazole; Humans; Miconazole; Mouth Neoplasms; Pneumonia, Aspiration; Random Amplified Polymorphic DNA Technique

Topics: Aged; Amphotericin B; Chronic Disease; Diagnosis, Differential; Female; Histoplasmosis; Humans; Ketoconazole; Maxillary Diseases; Mouth Diseases; Mouth Neoplasms; Ulcer

Topics: Adult; Aged; Amphotericin B; Candida albicans; Candidiasis, Oral; Humans; Middle Aged; Mouth; Mouth Mucosa; Mouth Neoplasms; Pharyngeal Neoplasms; Pharynx; Radiotherapy; Radiotherapy Dosage

Topics: Amphotericin B; Animals; Carcinoma; Cell Line; Cell Survival; Culture Media; Depression, Chemical; Dose-Response Relationship, Drug; Drug Synergism; HeLa Cells; Humans; L Cells; Leucine; Mice; Mouth Neoplasms; Polymyxins; Protein Biosynthesis; Rifampin; RNA, Neoplasm; Tetracycline; Tritium; Uridine

Topics: Adult; Aged; Amphotericin B; Blastomycosis; Diagnosis, Differential; Histoplasmosis; Humans; Laryngeal Diseases; Laryngeal Neoplasms; Lip Diseases; Male; Middle Aged; Mouth Diseases; Mouth Neoplasms; Mycoses

Topics: Adult; Aged; Amphotericin B; Candidiasis, Oral; Carcinoma, Squamous Cell; Chronic Disease; Humans; Hyperplasia; Male; Middle Aged; Mouth Neoplasms; Precancerous Conditions