EPSTEIN-BARR VIRUS POSITIVE (EBV+) ORAL ULCER IN PATIENT WITH POSTTRANSPLANT LYMPHOPROLIFERATIVE DISORDER

Abstract

A 55-year-old male patient, after hematopoietic stem cell transplantation (HSCT) due to myelodysplastic syndrome, presented plaques not resistant to scraping in the lingual ventral surface region 65 days after HSCT that were suggestive of oral candidiasis, for which he was prescribed topical antifungal and therapeutic dose of fluconazole. After 5 days, the patient developed cervical lymph node enlargement, increased oral plaques, and multiple oral ulcers. Both lymph nodes and oral lesions were Epstein-Barr virus (EBV)-positive, which contributed to the diagnosis of posttransplant lymphoproliferative disease (PTLD). The first-choice treatment was rituximab, which was started immediately. Symptomatic control and photodynamic therapy for oral ulcers were performed. After 2 months of follow-up, the lesions in the oral cavity improved, but the clinical condition worsened, and the patient died. Mucocutaneous ulcer EBV-positive is a clinical entity recently described in immunosuppressed patients that can assist in the diagnosis and institution of appropriate treatment for PTLD.