MULTIPLE STOMATITIS IN A PATIENT WITH GANGLIONIC TUBERCULOSIS

Abstract

An 18-year-old young man was referred for diagnosis of extensive lesions on the lips and oral mucosa. He reported a smoking habit and the recurrence of ganglionic tuberculosis during the interview, with significant weight loss. Medications in use included isoniazid (300 mg), ethambutol (1000 mg), pyraziamide (1000 g), and rifampicin (600 mg). Intraoral examination presented multiple painful ulcerated stomatitis, covered by a pseudomembrane, affecting the labial and buccal mucosa, tongue, and soft palate. The laboratory exams included herpes virus anti-(HV), cytomegalovirus anti-(CMV), fluorescent treponemal antibody absorption (FTA-ABS) negative; high IgE values, reagent for infectious mononucleosis (anti-virus capsid antigen (VCA)-IgM >160 U/mL). Screening for herpes virus in saliva presented positivity for HHV-7. With the diagnostic hypothesis of stomatitis associated with opportunistic infections, treatment consisted of antimicrobial photodynamic therapy, with substantial improvement in pain and reduction of lesions seen in the following 24 hours and full resolution of lesions 5 days after the first appointment.