ANTIMICROBIAL PHOTODYNAMIC THERAPY AS ADJUVANT IN THE TREATMENT OF BACTERIAL INFECTION OF A LIVER TRANSPLANTED PATIENT

Abstract

Patient N.J.E., a 69-year-old black male liver recipient, complained of pain in the oral cavity. Clinical examination revealed ulcerated lesions on the dorsal surface of the tongue, right buccal mucosa, and lower right vestibule. In view of clinical findings and medical history, the diagnostic hypothesis suggested an oral infection. The culture was carried out with the purpose of microbiologic analysis (swab) along with incisional biopsy of tongue lesion, leading to a diagnosis of Actinomyces infection. The patient was treated with specific antimicrobials, oral topical solutions, and, as an adjuvant, antimicrobial photodynamic therapy (aPDT). aPDT consisted of daily application of the photosensitizer on the lesions, and after 5 minutes, the low-level light laser was applied in the visible red spectrum (660 nm) with fixed power of 100 mW and energy density of 6 J/cm². After 15 days, good clinical tissue recovery was observed; however, because of other systemic complications, the patient died. Patient N.J.E., a 69-year-old black male liver recipient, complained of pain in the oral cavity. Clinical examination revealed ulcerated lesions on the dorsal surface of the tongue, right buccal mucosa, and lower right vestibule. In view of clinical findings and medical history, the diagnostic hypothesis suggested an oral infection. The culture was carried out with the purpose of microbiologic analysis (swab) along with incisional biopsy of tongue lesion, leading to a diagnosis of Actinomyces infection. The patient was treated with specific antimicrobials, oral topical solutions, and, as an adjuvant, antimicrobial photodynamic therapy (aPDT). aPDT consisted of daily application of the photosensitizer on the lesions, and after 5 minutes, the low-level light laser was applied in the visible red spectrum (660 nm) with fixed power of 100 mW and energy density of 6 J/cm². After 15 days, good clinical tissue recovery was observed; however, because of other systemic complications, the patient died.