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非霍奇金淋巴瘤中的口腔念珠菌病:一例报告

Oral candidosis in non-Hodgkin's lymphoma: a case report.

作者信息

Siar Chong Huat, Ng Kok Han, Rasool Salik, Ram Saravanan, Abdul Jalil Ajura, Ng Kee Peng

机构信息

Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

J Oral Sci. 2003 Sep;45(3):161-4. doi: 10.2334/josnusd.45.161.

Abstract

Though oral candidosis is an opportunistic fungal infection that commonly affects immunocompromised patients, little is known of its occurrence as a complication of Non-Hodgkin's lymphoma. This paper reports a case of oral candidosis in a 20-year-old Indonesian woman with this lymphoproliferative disease. She presented with acute pseudomembranous candidosis on the dorsum and lateral borders of the tongue, bilateral angular cheilitis and cheilocandidosis. The latter is a rare clinical variant of oral candidosis, and the lesions affecting the vermilion borders presented as an admixture of superficial erosions, ulcers and white plaques. Clinical findings were confirmed with oral smears and swabs that demonstrated the presence of hyphae, pseudohyphae and blastospores, and colonies identified as Candida albicans. A culture from a saline rinse was also positive for multiple candidal colonies. Lip and oral lesions were managed with Nystatin. The lesions regressed with subsequent crusting on the lips, and overall reduction in oral thrush. As Non-Hodgkin's lymphoma is a neoplastic disease that produces a chronic immunosuppressive state, management of its oral complications, including those due to oral candidosis, is considered a long-term indication.

摘要

尽管口腔念珠菌病是一种常见于免疫功能低下患者的机会性真菌感染,但对于其作为非霍奇金淋巴瘤并发症的发生情况却知之甚少。本文报告了一例患有这种淋巴增殖性疾病的20岁印度尼西亚女性口腔念珠菌病病例。她表现为舌背和舌侧缘急性假膜性念珠菌病、双侧口角炎和唇念珠菌病。后者是口腔念珠菌病一种罕见的临床变体,累及唇红缘的病变表现为浅表糜烂、溃疡和白色斑块的混合。口腔涂片和拭子检查证实了临床发现,显示有菌丝、假菌丝和芽生孢子,菌落鉴定为白色念珠菌。盐水漱口液培养也显示多个念珠菌菌落阳性。唇部和口腔病变采用制霉菌素治疗。病变消退,随后唇部结痂,口腔鹅口疮总体减轻。由于非霍奇金淋巴瘤是一种导致慢性免疫抑制状态的肿瘤性疾病,对其口腔并发症(包括由口腔念珠菌病引起的并发症)的处理被视为一项长期治疗指征。

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