Nurina Febriyanti Ayuningtyas,1,2 Desiana Radithia,2 Adiastuti Endah2

Resident, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia

Lecturer, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia

Abstract

Objective: HIV infection can cause severe damage to the immune system due to destruction of the CD4+ cells. This condition makes HIV-infected person vulnerable to opportunistic infection, including oral candidiasis. Oral candidiasis can be an early clinical finding in someone with impaired immunity. The immunodeficiency state in HIV infected patients has been the cause of severe episodes of Recurrent Aphthous Stomatitis (RAS), leading to nutritional deficit and a poor quality of life.

This study presents a case of major recurrent aphthous stomatitis and oral candidiasis as manifestation of immune deficiency in HIV infection. A 48-year-old female complained of painful lesions dispersed on her tongue and corner of the lips causing disturbance while eating due to severe pain. The patient had been diagnosed with HIV-AIDS since early 2018. Patient's general condition was poor. Extraoral examination showed an ulcer surrounded by reddened crusting. Intraoral examination showed extensive painful ulcer on dorsal tongue and a white pseudomembrane which could be scraped off leaving a reddened layer on tongue.

Methods: Management included anamnesis, clinical examination, and laboratory examination of complete blood panel and swab from the pseudomembranous layer then performing direct and indirect mycology examination. Patient was instructed to take medicine regularly. Patient was given nystatin 100.000 IU, fluconazole 150 mg and antiretrovirals by an internist and was prescribed Oxyfresh dental gel. The lesion healed in 14 days.