Maria Cecília Freire de Melo1, Thuanny Silva de Macedo1, Julianelly Alves Biserra2, Karina Luz Cavalcanti Rodrigues3, Mônica Cruz4, Aurora Karla de Lacerda Vidal1,5. 1. Resident Dentist, Residency Program in Hospital Dentistry Focusing on Oncology, University of Pernambuco, ICB/HUOC/UPE. 2. Resident Dentist, Residency Program in Palliative Care, University of Pernambuco, ICB/HUOC/UPE. 3. Specialist in Pediatric Oncology, Pediatric Oncology and Hematology Center, Oswaldo Cruz University Hospital, CEONPE/HUOC. 4. Dentist, Pediatric Oncology and Hematology Center of the Oswaldo Cruz University Hospital, CEONPE/HUOC. 5. Profa. Dra. Adjunct Regent, General Pathological Processes Discipline, ICB/UPE, Chief Dentist, Dentistry Service, CEON/HUOC/UPE, and Coordinator, Residency Program in Hospital Dentistry Focusing on Oncology, University of Pernambuco, ICB/HUOC/UPE.
Abstract
AIM: To report a case of a pediatric patient carrier of myelodysplastic syndrome (MDS) with severe oral infectious disease, in which antimicrobial photodynamic therapy (aPDT) was used as a therapeutic choice to support systemic treatment. METHODS AND RESULTS: This case report refers to a 1-year-old male patient with MDS and hospitalized for investigation and treatment of complications at a Pediatric Oncology and Hematology Center in Recife/PE, Brazil. The intraoral examination revealed a violaceous lesion surrounding the lower incisor teeth, which progressed with alteration of color to milky yellowish white, compromising the entire lower gingival border, leading to tooth mobility and consequent loss of teeth 71 and 81. The patient was treated under systemic antimicrobial therapy and aPDT was also performed, using a photosensitizing agent (methylene blue, 0.01%) and a low-intensity laser in the visible red spectrum. Oral clinical improvement was observed, but the patient died after 45 days of hospitalization in the Pediatric ICU due to other systemic complications. CONCLUSION: MDS may present limiting oral repercussions interfering in patients' quality of life. The aPDT is presented as an adjuvant therapeutic modality in oral infections with satisfactory results.
AIM: To report a case of a pediatric patient carrier of myelodysplastic syndrome (MDS) with severe oral infectious disease, in which antimicrobial photodynamic therapy (aPDT) was used as a therapeutic choice to support systemic treatment. METHODS AND RESULTS: This case report refers to a 1-year-old male patient with MDS and hospitalized for investigation and treatment of complications at a Pediatric Oncology and Hematology Center in Recife/PE, Brazil. The intraoral examination revealed a violaceous lesion surrounding the lower incisor teeth, which progressed with alteration of color to milky yellowish white, compromising the entire lower gingival border, leading to tooth mobility and consequent loss of teeth 71 and 81. The patient was treated under systemic antimicrobial therapy and aPDT was also performed, using a photosensitizing agent (methylene blue, 0.01%) and a low-intensity laser in the visible red spectrum. Oral clinical improvement was observed, but the patient died after 45 days of hospitalization in the Pediatric ICU due to other systemic complications. CONCLUSION:MDS may present limiting oral repercussions interfering in patients' quality of life. The aPDT is presented as an adjuvant therapeutic modality in oral infections with satisfactory results.