Yuliana1, Silfra Yunus Kende1, Rina Kartika1, Diah Savitri Ernawati2

Resident of Oral Medicine Specialist Programme, Faculty of Dental Medicine, Airlangga University

Lecturer of Oral Medicine Department, Faculty of Dental Medicine, Airlangga University

Abstract

Introduction: Necrotising ulcerative stomatitis (NUS) and Oral Candidiasis are oral manifestations that often occur in immunocompromised conditions such as patient with HIV/AIDS. HIV infection causes a reduction in CD4 T-lymphocyte levels, the individual's defense against pathogenic microorganisms becomes weak and increases the risk of secondary infection, which often results in the appearance of infections such as NUS and Oral Candidiasis.

Objective: A case study to describe the oral lesions found in patients with HIV/AIDS. 

Case Review: A 47-year-old male patient came to the dental clinic of  Airlangga University Hospital (RSUA) Surabaya complaining of painful canker sores on the cheeks and gums around the upper left molars that had not healed for two weeks as well as white patches in his mouth. There had been 10 kg weight loss in the last year, itching of the legs and body that had started two years previously. The patient had tested HIV positive at the referring health center. Intra-oral examination found major ulcerating lesions; the base of the lesion displayed yellowish grey necrotic tissue, and white pseudomembranes in the mucosa.

Discussion: The provision of systemic antiretroviral medication suppresses replication of the HIV virus, so that the number of T-CD4 lymphocytes becomes relatively stable over the long term. Debridement of the lesions was undertaken, followed by topical analgesic, topical antibacterial and antifungal agents, and a systemic anti-fungal drug.

Initial repair of the lesions became visible after five days of treatment with chlorhexidine gluconate 0.2% topical mouth rinses three times a day, nystatin drops, drops four times a day and 200 mg ketoconazole tablets twice daily.

Conclusion: NUS and Oral Candidiasis are included in the group of oral lesions which are recognised as clinical manifestations of HIV/AIDS infection.