trimethoprim--sulfamethoxazole-drug-combination and Gingivitis

Topics: Adult; Anti-Bacterial Agents; Antiretroviral Therapy, Highly Active; Combined Modality Therapy; Debridement; Drug Therapy, Combination; Female; Gingivitis; Gingivoplasty; Heroin Dependence; HIV Infections; Humans; Mandible; Methadone; Necrosis; Oral Ulcer; Pain; Stomatitis; Substance Abuse, Intravenous; Tooth Extraction; Tooth Loss; Treatment Refusal; Trimethoprim, Sulfamethoxazole Drug Combination

Generalised prepubertal periodontitis is a rare entity that is usually a consequence of severe systemic diseases. Chronic granulomatous disease is one of the extremely rare inherited immunodeficiency diseases, which predisposes the patient to recurrent severe bacterial and fungal infections.. The purpose of this report is to describe a 5-year old male patient suffering from prepubertal periodontitis associated with chronic granulomatous disease, who was referred to the Department of Periodontology for treatment of severe gingival inflammation.. A detailed past history was obtained and thorough clinical and laboratory examinations were performed.. Medical tests revealed the only immunodeficiency sign as the extremely low burst test result. The patient was diagnosed as having an autosomal recessive (AR) form of chronic granulomatous disease. He was put on prophylactic treatment with trimethoprim-sulfamethoxazole (TMP-SMX) and also a periodontal maintenance regimen with regular 1-month intervals.. This case report emphasises the importance of the differential diagnosis of severe immunodeficiency in the background of prepubertal periodontitis.

Topics: Aggressive Periodontitis; Anti-Infective Agents; Child, Preschool; Diagnosis, Differential; Disease Susceptibility; Follow-Up Studies; Genes, Recessive; Gingivitis; Granulomatous Disease, Chronic; Humans; Male; Recurrence; Trimethoprim, Sulfamethoxazole Drug Combination

We report a case of Wegener's granulomatosis (WG), localised to the upper aerodigestive tract, which presented as an unusual form of hyperplastic gingivitis in a 36-year-old female. The clinical, serological and histopathological findings are described. The resemblance of the affected gums to over-ripe strawberries is emphasised, in order to draw attention to this characteristic oral manifestation of a rare and potentially life-threatening condition. The response to co-trimoxazole as sole therapy is noted.

Topics: Adult; Female; Gingival Hyperplasia; Gingivitis; Granulomatosis with Polyangiitis; Humans; Trimethoprim, Sulfamethoxazole Drug Combination