MAJOR APHTHOUS ULCER IN A PATIENT WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME

Abstract

Oral manifestations in acquired immune deficiency syndrome (AIDS) occur in a large proportion of patients. A 28-year-old man with AIDS was referred from medicine service due to multiple oral lesions of unknown clinical progress. The patient presented with lymphopenia (a CD4+ T-cell count of 11 cell/μL) and noncompliance with antiretroviral treatment (viral load 59,100 copies/mL). An extensive ulcer of 30 × 14 mm with a marked erythematous halo on the left buccal mucosa was observed. An incisional biopsy and a culture were performed to evaluate for the presence of infectious diseases. Definitive diagnosis was major aphthous ulcer in an AIDS patient. Oral hygiene was carried out together with highly active antiretroviral treatment. Complete healing was observed within 6 weeks’ follow-up, improvement of the CD4+ count, a decrease in the viral load, and absence of recurrence signs. It is important to make a differential diagnosis of oral lesions in patients with AIDS to establish the proper treatment.