Abstract
A female patient, 47 years old, presented 3 years after allogeneic hematopoietic stem cell transplantation related to myelodysplastic syndrome in immunosuppression for chronic graft-versus-host (GVHD) disease treatment for the mouth, eyes, and skin grade II lesions. The patient reported significant burning in the oral mucosa. Oral examination showed an erythematous and bleeding mucosa with multiple shallow ulcerations. Anatomopathology identified inflammation without criteria for GVHD. Grocott methenamine silver and Ziehl-Neelsen staining, immunohistochemistry, viral PCR, and fungal and bacteria cultures were negative for infection. Amplification of the 16S rDNA gene for mycoplasma was performed by means of real-time PCR that presented positive results in all triplicates (Ct≅27; 103 genome copies/μL). Sequencing of samples (ABI 3500xL Genetic Analyzer, ThermoFisher Scientific) showed 99% genetic identity with Mycoplasma salivarium (MS-accession number NR_113661.1). Seventy-two hours after doxycycline treatment, complete resolution of oral lesions was observed, and PCR for MS after 10 days was negative. MS infections should be considered in nonspecific acute inflammatory processes, especially after HSCT.
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