Oral Ulcers Induced by Cytomegalovirus Infection: Report on Two Cases

Abstract

Human cytomegalovirus (CMV) is a virus that can compromise the lungs and the liver and cause infection in the gastrointestinal tract. In addition, this virus can cause infectious mononucleosis syndrome, infection in the CNS, and retinitis. Moreover, it has been associated with the development of oral hairy leukoplakia and ulcers. Objective: To report two cases of patients with HIV with oral manifestations associated with CMV infection. Case Report: In the first case, the patient sought medical attention, with complaints of weakness, fever, cough, and weight loss. In the second case, the patient complained of weakness and blurred vision for about a week. Both patients were infected with HIV and made irregular use of antiretroviral therapy. Several ulcers were observed in the mouth that caused much discomfort. The diagnosis of CMV infection was defined by the following tests: enzyme immunoassay fluorescence-CMV IgG and PCR for CMV in real time. Ganciclovir has been used in the treatment of patients, and oral ulcerations received symptomatic treatment. Conclusion: The dentist must be aware that CMV may also be responsible for the development of ulcers in the oral cavity, especially in immunocompromised patients.

Oral manifestations associated with concurrent CMV and HSV-1 in children with cerebri abses: rare case report

“…Beberapa penelitian menjelaskan bahwa imunosupresi menghasilkan reaktivasi CMV, karena imunosupresi akan mempengaruhi imunitas humoral dan seluler dengan terjadi penekanan fungsi limfosit-T sitotoksik dan monosit yang diinduksi limfosit dan akan menyebabkan lesi pada rongga mulut. 4,6,7 Penyakit imunocompromised seperti abses serebri memicu infeksi virus, contohnya HSV-1 dan CMV. Abses serebri merupakan penumpukan pus akibat infeksi pada otak yang bisa menyebabkan pembengkakan pada otak yang sering disebabkan oleh infeksi bakteri atau jamur yang dipicu oleh cedera kepala atau infeksi jaringan tubuh lain yang menyebar ke otak.…”

Case Series of HIV-Associated Oral Lesions Among Antiretroviral-Naive Patients During the COVID-19 Pandemic

“…Like other types of herpes viruses, this CMV virus can be latent and can reactivate under possible conditions such as stress, immunosuppression, autoimmune diseases, and during chemotherapy. 36 CMV infection is an opportunistic infection that often occurs in HIV patients. 37 When CD4+ T lymphocytes are reduced in number as occurs in immunocompromised patients, CMV can be reactivated and cause disease.…”

“…In the oral cavity, the manifestation can be in the form of ulcers. 36 To establish the diagnosis of CMV ulcers, clinical examination and laboratory tests are carried out to determine antibodies to CMV or by detection of viral DNA by polymerase chain reaction (PCR).…”