Oral Opportunistic Infections in Patient with HIV Wasting Syndrome

Mega Rafika, Tenny Setiani Dewi

Abstract


Background: Human immunodeficiency virus (HIV) wasting syndrome is a condition in which weight loss, fever, and chronic diarrhea occur for more than 30 days without any causes other than HIV infection. HIV causes an immunocompromised condition resulting in susceptibility to infection. The opportunistic infections are oral candidiasis, herpes simplex virus (HSV), and tuberculosis. This study aims to explain oral opportunistic infections in a patient with wasting syndrome. Case Report: A 20-year-old female, who was 165 cm in height and 33.75 kg in weight, with wasting syndrome, pulmonary tuberculosis, oral candidiasis, and angular cheilitis was referred from an internist in Hasan Sadikin Hospital. Extraoral examination showed a yellowish brownish crust on the lips. Intraoral examination showed multiple ulcers covered by a yellowish membrane on the labial mucosa. The white plaques were scrapable, and an erythematous was found on the dorsum of the tongue, buccal mucosa, and palate. Laboratory results revealed a decrease in hemoglobin, hematocrit, leucocyte, erythrocyte, basophil, neutrophil, lymphocyte, albumin, reactive anti-HSV IgG, CD4 16 cell/µl, mycology culture test, chest x-ray, and sputum. On the basis of anamnesis, clinical features, and laboratory examination, the patient was diagnosed with stomatitis herpetica and oral candidiasis. Chlorhexidine gluconate 0.2%, nystatin oral suspension, vitamin B12, folic acid, and vaseline album were administered on the lips. Clinical recovery of oral candidiasis was accomplished after five weeks of therapy. Conclusion: Opportunistic infections in patient with wasting syndrome are oral candidiasis, herpetic stomatitis, and tuberculosis.


Keywords


opportunistic infections; wasting syndrome

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References


De pee S, Semba RD. Role of nutrition in HIV infection: Review of evidence for more effective programming in resource-limited settings. Food Nutr Bull. 2010; 31(4): S313-S344. DOI: 10.1177/15648265100314S403

Eden JS, Chisholm RH, Bull RA, White PA, Holmes EC, and Tanaka MM. Persistent infections in immunocompromised hosts are rarely sources of new pathogen variants. Virus Evolution. 2017; 3(2): 1-9. DOI: 10.1093/ve/vex018

Rautemaa R, and Ramage G. Oral candidosis–clinical challenge of a biofilm disease. Crit Rev in Microbiol. 2011; 37(4): 328-36. DOI: 10.3109/1040841X.2011.585606

Garcia-Cuesta C, Sarrion-Perez MG, Bagan JV. Current treatment of oral candidiasis : A literature review. J Clin Exp Dent. 2014; 6(5): e576-82. DOI: 10.4317/jced.51798

Arvind S, Ishita G, Charantimath SM. Oral candidiasis: aiding in the diagnosis of HIV-a case report. Case Rep Dent. 2011; 929616. DOI: 10.1155/2011/929616

Muzkya BC, Epifanio RN. Update on oral Fungal Infections. Dent Clin North Am. 2013 Oct;57(4):561-8. DOI: 10.1016/j.cden.2013.07.002

Fourie J, Khammissa RAG, Ballyram R, Wood N, Lemmer J, Feller L. Oral candidosis : an update on diagnosis, aetiopathogenesis and management. J Dent Assoc S Afr. 2016; 71(7): 314-8.

Mushi MF, Bader O, Taverne-Ghadwal L, Bii C, Groß U, Mshana SE. Oral candidiasis among African human immunodeficiency virus-infected individuals: 10 years of systematic review and meta-analysis from sub-saharan Africa. J Oral Microbiol. 2017; 9(1): 1317579. DOI: 10.1080/20002297.2017.1317579

Chandrasekaran P, Saravanan N, Bethunaickan R, and Tripathy S. Malnutrition: Modulator of Immune Responses in Tuberculosis. Front Immunol. 2017;8:1316. DOI: 10.3389/fimmu.2017.01316

Berberi A, Noujeim Z. Epidemiology and Relationships between CD4+ Counts and Oral Lesions among 50 Patients Infected with Human Immunodeficiency Virus. J Int Oral Health. 2015 Jan;7(1):18-21

Ngasala G, Mgabo MR, Mrema JG, Sabuni J, Mwakalinga S, Kajeguka DC. Oral candida infection among HIV patients at Kilimanjaro christian medical centre in Northern, Tanzania. Tanzan J Health Res. 2016; 18(1): 1-8. DOI: 10.4314/thrb.v18i1.8

Coronado-Castellote L, Jiménez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent. 2013; 5(5): e279-86. DOI: 10.4317/jced.51242

Chidzonga MM, Mwale M, Malvin K, Martin JN, Greenspan JS, Shiboski CH. Oral candidiasis as a marker of HIV disease progression among Zimbabwean women. J Acquir Immune Defic Syndr. 2008; 47(5): 579-584. DOI: 10.1097/QAI.0b013e318160a554

Kumar K.L, Gowda S, Basavarajaiah. Incidence of oral candidiasis among HIV infected patients-cohort prospective study. Intern J Scientific and Research Publications. 2013; 3(12): 1-6.

odríguez EJ, Mayor AM., Santos DM, Mellado RF. Profile of HIV-Infected Hispanics with Pancytopenia. Int. J. Environ. Res. Public Health. 2016; 13: 38. DOI: 10.3390/ijerph13010038

Nemeth E, Ganz T. Anemia of inflammation. Hematol Oncol Clin North Am. 2014; 28(4): 671-81. DOI: 10.1016/j.hoc.2014.04.005

Adamson JW. The anemia of inflammation/malignancy: mechanisms and management. Hematology Am Soc Hematol Educ Program. 2008:159-65. DOI: 10.1182/asheducation-2008.1.159

Van de perre PV, Segondy M, Foulongne V, Edraogo A, Konate I, Huraux JM, et al. Herpes simplex virus and HIV-1: deciphering viral synergy. Lancet Infect Dis. 2008; 8(8): 490-97. DOI: 10.1016/S1473-3099(08)70181-6

Bowers LM, Fox PC, Brennan MT. Salivary gland disease. In: Glick M, M William, editors. Burket’s Oral Medicine. 12th ed. Connecticut: People’s Medical Publishing House; 2015. p.219-24.

van-Velzen M. Herpes simplex virus type I infection: feature of immune surveillance and antiviral resistance. [Thesis]. Rotterdam. Erasmus University Rotterdam; 2013.

Shah S, Devi P, Ravindra et al. Primary herpetic gingivostomatitis: a case report and review of literature. TMU J Dent. 2014; 1(3): 119-124.

Mohan RP, Verma S, Singh U, Agarwal N. Acute primary herpetic gingivostomatitis. BMJ Case Rep. 2013; 2013. pii: bcr2013200074. DOI: 10.1136/bcr-2013-200074

Monica B, Gupta MY. Oral candidiasis and AIDS. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2013; 11(4): 29-32.

Duggal S, Chugh TD, and Duggal AK. HIV and malnutrition: effects on immune system. Clin Dev Immunol. 2012;2012:784740. DOI: 10.1155/2012/784740

Feller L, Khammissa RA, Chandran R, Altini M, Lemmer J. Oral candidosis in relation to oral immunity. J Oral Pathol Med. 2014; 43(8):563-9. DOI: 10.1111/jop.12120.

de Repentigny L, Goupil M, Jolicoeur P. Oropharyngeal candidiasis in HIV infection: analysis of impaired mucosal immune response to candida albicans in mice expressing the HIV-1 transgene. Pathogens. 2015 Jun 23;4(2):406-21. DOI: 10.3390/pathogens4020406.

Nemeth E, Ganz T. Anemia of Inflammation. Hematol Oncol Clin North Am. 2014 Aug;28(4):671-81, vi. DOI: 10.1016/j.hoc.2014.04.005.

Dusingize JC1, Hoover DR, Shi Q, Mutimura E, Kiefer E, Cohen M, et al. Association of serum albumin with markers of nutritional status among HIV-Infected and Uninfected Rwandan Women. PLoS One. 2012 April; 7(14); e35079. DOI: 10.1371/journal.pone.0035079

Tarçın GB, Oral candidosis: aetiology, clinical manifestations, diagnosis and management. Musbed. 2011; 1(2): 140-148.

Ivers LC1, Cullen KA, Freedberg KA, Block S, Coates J, Webb P. HIV/AIDS, undernutrition, and food insecurity. Clin Infect Dis. 2009 Oct 1;49(7):1096-102. DOI: 10.1086/605573.

Rose AM, Hall CS, Martinez-Alier N. Aetiology and management of malnutrition in HIV-positive children. Arch Dis Child. 2014; 99(6): 546-51. DOI: 10.1136/archdischild-2012-303348.




DOI: http://dx.doi.org/10.26912/sdj.v3i1.3608

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