Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report
Abstract Background Allogeneic hematopoietic stem cell transplant (allo-HSCT) is used to treat several hematological diseases, but immunosuppression during allo-HSCT facilitates opportunistic microbial growth in tissues, such as actinomycosis. An effective diagnosis of opportunistic diseases is esse...
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Oral Health |
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| Online Access: | https://doi.org/10.1186/s12903-023-02777-7 |
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| author | Julia Stephanie Bruno Wanessa Miranda-Silva Vitor Heidrich Marianne de Castro Gonçalves Yana Novis Celso Arrais-Rodrigues Anamaria Aranha Camargo Eduardo Rodrigues Fregnani |
| author_facet | Julia Stephanie Bruno Wanessa Miranda-Silva Vitor Heidrich Marianne de Castro Gonçalves Yana Novis Celso Arrais-Rodrigues Anamaria Aranha Camargo Eduardo Rodrigues Fregnani |
| author_sort | Julia Stephanie Bruno |
| collection | DOAJ |
| description | Abstract Background Allogeneic hematopoietic stem cell transplant (allo-HSCT) is used to treat several hematological diseases, but immunosuppression during allo-HSCT facilitates opportunistic microbial growth in tissues, such as actinomycosis. An effective diagnosis of opportunistic diseases is essential for correct management of the disease and preservation of the immunosuppressed patient’s life. Case description A 57-year-old female patient was diagnosed with extranodal nasal type NK/T cell lymphoma and underwent curative treatment with allo-HSCT. Twenty-one days after the last clinical follow-up, the patient presented a necrotizing lesion in the papilla region between the first and second molars of the second quadrant. Histopathological analysis showed the presence of a bacterial cluster consistent with Actinomyces infection, and a dense lymphoid infiltrate was also observed. Immunohistochemistry for CD20, CD3, and CD56 was performed to exclude the possibility of the recurrence of extranodal NK/T cell lymphoma. Oral microbiota profiling showed a huge increase in the abundance of Actinomyces bacteria in the subgingival region three weeks prior to appearance of the lesion. Conclusions Opportunistic infections with an unusual clinical appearance are confounding factors in therapeutic decision-making. We present for the first time a case of actinomycosis in the gingival papilla region following allo-HSCT. We also highlight how microbiota profiling through next-generation sequencing could be used to anticipate bacterial infection diagnosis. |
| first_indexed | 2024-04-10T17:15:18Z |
| format | Article |
| id | doaj.art-8d70b2281fe64522a998ff4eae68d8b4 |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-04-10T17:15:18Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-8d70b2281fe64522a998ff4eae68d8b42023-02-05T12:25:54ZengBMCBMC Oral Health1472-68312023-02-012311710.1186/s12903-023-02777-7Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case reportJulia Stephanie Bruno0Wanessa Miranda-Silva1Vitor Heidrich2Marianne de Castro Gonçalves3Yana Novis4Celso Arrais-Rodrigues5Anamaria Aranha Camargo6Eduardo Rodrigues Fregnani7Centro de Oncologia Molecular, Hospital Sírio-LibanêsCentro de Oncologia Molecular, Hospital Sírio-LibanêsCentro de Oncologia Molecular, Hospital Sírio-LibanêsCentro de Oncologia, Hospital Sírio-LibanêsCentro de Oncologia, Hospital Sírio-LibanêsHospital Nove de Julho, Rede DASACentro de Oncologia Molecular, Hospital Sírio-LibanêsCentro de Oncologia Molecular, Hospital Sírio-LibanêsAbstract Background Allogeneic hematopoietic stem cell transplant (allo-HSCT) is used to treat several hematological diseases, but immunosuppression during allo-HSCT facilitates opportunistic microbial growth in tissues, such as actinomycosis. An effective diagnosis of opportunistic diseases is essential for correct management of the disease and preservation of the immunosuppressed patient’s life. Case description A 57-year-old female patient was diagnosed with extranodal nasal type NK/T cell lymphoma and underwent curative treatment with allo-HSCT. Twenty-one days after the last clinical follow-up, the patient presented a necrotizing lesion in the papilla region between the first and second molars of the second quadrant. Histopathological analysis showed the presence of a bacterial cluster consistent with Actinomyces infection, and a dense lymphoid infiltrate was also observed. Immunohistochemistry for CD20, CD3, and CD56 was performed to exclude the possibility of the recurrence of extranodal NK/T cell lymphoma. Oral microbiota profiling showed a huge increase in the abundance of Actinomyces bacteria in the subgingival region three weeks prior to appearance of the lesion. Conclusions Opportunistic infections with an unusual clinical appearance are confounding factors in therapeutic decision-making. We present for the first time a case of actinomycosis in the gingival papilla region following allo-HSCT. We also highlight how microbiota profiling through next-generation sequencing could be used to anticipate bacterial infection diagnosis.https://doi.org/10.1186/s12903-023-02777-7Oral diseasesActinomycosisOral microbiotaAllogeneic hematopoietic stem-cell transplant |
| spellingShingle | Julia Stephanie Bruno Wanessa Miranda-Silva Vitor Heidrich Marianne de Castro Gonçalves Yana Novis Celso Arrais-Rodrigues Anamaria Aranha Camargo Eduardo Rodrigues Fregnani Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report BMC Oral Health Oral diseases Actinomycosis Oral microbiota Allogeneic hematopoietic stem-cell transplant |
| title | Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report |
| title_full | Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report |
| title_fullStr | Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report |
| title_full_unstemmed | Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report |
| title_short | Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report |
| title_sort | unusual gingival actinomycosis post allogeneic hematopoietic stem cell transplant case report |
| topic | Oral diseases Actinomycosis Oral microbiota Allogeneic hematopoietic stem-cell transplant |
| url | https://doi.org/10.1186/s12903-023-02777-7 |
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