ACUTE NECROTIZING ULCERATIVE GINGIVITIS IN ONCOPEDIATRIC PATIENTS: CHALLENGES IN TREATMENT

Abstract

Acute necrotizing ulcerative gingivitis (ANUG) is a serious complication that can occur in children with neutropenia after chemotherapy. Early diagnosis and assertive treatment can prevent fatal progression due to sepsis. Our goal is to report the case of a 2-year-old female patient undergoing treatment for acute lymphoid leukemia who developed ANUG in the attached gingiva of the maxilla and hard palate after the first block of chemotherapy with daunorubicin and vincristine. The patient had progressive and quick worsening even with local hygiene measures, photobiomodulation, and broad-spectrum antibiotic therapy. Her general health condition did not allow surgical debridement because she was severely neutropenic and thrombocytopenic. On the sixth day after the appearance of the first spot of gingival necrosis, the patient died from sepsis of pulmonary and oral foci that culminated in cardiorespiratory arrest. Acute necrotizing ulcerative gingivitis (ANUG) is a serious complication that can occur in children with neutropenia after chemotherapy. Early diagnosis and assertive treatment can prevent fatal progression due to sepsis. Our goal is to report the case of a 2-year-old female patient undergoing treatment for acute lymphoid leukemia who developed ANUG in the attached gingiva of the maxilla and hard palate after the first block of chemotherapy with daunorubicin and vincristine. The patient had progressive and quick worsening even with local hygiene measures, photobiomodulation, and broad-spectrum antibiotic therapy. Her general health condition did not allow surgical debridement because she was severely neutropenic and thrombocytopenic. On the sixth day after the appearance of the first spot of gingival necrosis, the patient died from sepsis of pulmonary and oral foci that culminated in cardiorespiratory arrest.