ORAL ASPERGILLOSIS DIAGNOSIS IN ONCOHEMATOLOGIC PATIENTS: CASE SERIES

Abstract

We report a series of 12 cases of oral aspergillosis with an age range from 21 to 63 years (mean, 42 y), 7 women, 5 men, whose underlying diseases were acute myeloid leukemia (n = 9) and chronic myeloid leukemia in blastic crisis (n = 3). Primary sites and symptoms were: 2 cases in the nasal cavity presenting as rhinorrhea and fever, 5 cases in the paranasal sinus (2 with pain, 1 with fever and 2 with pain and fever), and 5 cases in the oral mucosa who presented only with pain. All cases localized in paranasal sinuses were detected by computed tomography while in the nasal cavity; however, none were detected by imaging when localized to the oral mucosa. Galactomannan (GM) was positive only when fever was present. Histopathology (HP) and culture were all positive for Aspergillus sp., however HP diagnosis was within 48 hours. In conclusion, GM was not effective for localized lesions without systemic repercussion and histopathologic examination is strongly recommended for early aspergillosis diagnosis.