povidone-iodine and Neutropenia

Kostmann syndrome is a rare, congenital immunological disorder caused by a mutation of the hematopoietic cell-specific LYN substrate 1-associated protein X1. These patients pose a unique challenge to the dental practitioner due to the severe oral infections that are often seen in this population. The patient described in this report is a 16-year-old female with Kostmann syndrome-associated periodontitis. The treatment consisted of scaling and root planing performed in conjunction with subgingival irrigation with povidone-iodine solution. This report details how Kostmann syndrome-associated periodontitis can be successfully treated and maintained long-term, using non-surgical treatment modalities and local antimicrobial therapy.

Topics: Adolescent; Anti-Infective Agents, Local; Congenital Bone Marrow Failure Syndromes; Dental Scaling; Female; Follow-Up Studies; Furcation Defects; Gingival Recession; Gingivitis; Humans; Neutropenia; Periodontal Debridement; Periodontal Pocket; Periodontitis; Povidone-Iodine; Root Planing; Therapeutic Irrigation

Bacteria that adhere to damaged tissues encase themselves in a hydrated matrix of polysaccharides, forming a slimy layer known as a biofilm. This is the first report of detection of glycocalyx production by Staphylococcus aureus using confocal laser scanning microscopy (CLSM) on damaged skin tissues.. To analyse glycocalyx production by S. aureus cells on damaged skin tissues and the influence of polymorphonuclear leucocytes (PMNs) and various antimicrobial agents on its production using CLSM in cyclophosphamide (Cy)-treated (neutropenic) or non-Cy-treated (normal) mice.. S. aureus cells were inoculated on damaged skin tissues in neutropenic or normal mice with or without topical application of antimicrobial agents. S. aureus cells were stained with safranine, and positive staining with fluorescein isothiocyanate-conjugated concanavalin A was considered to indicate the presence of glycocalyx.. All S. aureus cells tested on damaged skin tissues formed microcolonies encircled by glycocalyx. The colony counts of S. aureus cells on croton oil dermatitis in normal mice treated with 2% fusidic acid ointment were about 100 times lower than those in neutropenic mice (control).. As S. aureus cells can generally produce a biofilm on damaged skin tissues, antimicrobial agents may not eradicate S. aureus cells without the help of PMNs. S. aureus glycocalyx may play a crucial role in colonization and adherence to damaged skin tissues.

Topics: Animals; Anti-Infective Agents, Local; Biofilms; Colony Count, Microbial; Dermatitis, Contact; Female; Fusidic Acid; Glycocalyx; Mice; Microscopy, Confocal; Neutropenia; Opportunistic Infections; Povidone-Iodine; Skin; Staphylococcal Infections; Staphylococcus aureus

This is the first known case report that used a polymerase chain reaction (PCR)-based method to help identify the oral microflora in patients with chronic neutropenia. In this study, we report clinical periodontal findings and microflora profiles of 2 children, 1 with severe congenital neutropenia (SCN, Kostmann type) and 1 with cyclic neutropenia (CN).. The SCN patient had severe gingivitis, whereas the patient with CN had mild gingivitis in the gingival margins. Monthly oral cleaning instruction and review were performed without subsequent periodontal therapy. Oral hygiene conditions remained satisfactory and visible plaque was scarce, despite the persistence of mild gingivitis. Under supervised oral hygiene, we examined the presence of periodontal pathogens from patient plaque samples.. By a PCR-based method, Prevotella nigrescens, Bacteroides forsythus, Campylobacter rectus, and Capnocytophaga gingivalis were detected in the SCN patient and P. intermedia, C. rectus, C. gingivalis, and C. sputigena in the CN patient, suggesting the existence of periodontal pathogens. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and C. ochracea were not found in either patient.. Use of 1% povidone iodine solution and local antibiotic application under supervised oral hygiene were helpful to improve gingival conditions in patients with chronic neutropenia.

Topics: Aggregatibacter actinomycetemcomitans; Anti-Infective Agents, Local; Bacteroides; Campylobacter; Capnocytophaga; Child, Preschool; Chronic Disease; Dental Plaque Index; Gingival Diseases; Gingival Hemorrhage; Gingival Pocket; Gingivitis; Gram-Negative Bacteria; Humans; Male; Neutropenia; Oral Hygiene; Periodicity; Polymerase Chain Reaction; Porphyromonas gingivalis; Povidone-Iodine; Prevotella; Prevotella intermedia; Treponema

Topics: Adult; Agranulocytosis; Anti-Bacterial Agents; Burns; Humans; Iodine; Male; Neutropenia; Povidone; Povidone-Iodine; Sepsis