Oral amoebiasis with acute myeloblastic leukemia

Abstract is not required for Letter to Editoris not required for Letter to Editor (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 7 No. 7, July 2016. ISSN – [0976-3198] Int J Case Rep Images 2016;7(7):486–487. www.ijcasereportsandimages.com Mitate et al. 486 CASE REPORT OPEN ACCESS Oral amoebiasis with acute myeloblastic leukemia Eiji Mitate, Kazunari Oobu, Tamotsu Kiyoshima, Seiji Nakamura


To the Editors,
Oral manifestations are frequent seen in immunocompromised patients. In some cases, Entamoeba gingivalis, was isolated and described by Gros G. [1], is found in periodontal disease [2], under chemotherapy [3], HIV(+)/AIDS patients [4] and acute osteomyelitis [5]. To our knowledge, this is the first case report of oral amoebiasis in immunocompromised patients with acute myeloblastic leukemia (AML). A 63-year-old male had painful refractory palatal and lower gingival ulcers ( Figure  1A-B). Each ulcer was filled with necrotic tissue and had a 5-mm induration. Some large and enhanced cervical lymph nodes were detected on computed tomography (Figure C) scan. Brush cytological examination revealed oral amoebiasis without malignancy ( Figure D). Vitamin B12 and folic acid were administrated for anemia. Blood examination revealed the following values: white blood cells 990/μl, red blood cells 1.32x10 6 /μl; and hemoglobin 4.8 g/dl, with higher hemoglobin F level. The patient was

LETTERS TO ThE EdiTOR PEER REviEwEd | OPEN ACCESS
referred to the hematology department, where he was diagnosed as having AML (M2) after bone marrow biopsy. Remission induction treatment (idarubicin hydrochloride and cytarabine) was initiated. Aspergillus pneumonia, bacteremia in trichosporonosis, and tuberculous cervical lymphadenitis were also treated. After two months of remission, agranulocytosis and recurring AML were detected. During chemotherapy for AML, the patient died of trichosporonosis-related pneumonia. E. gingivalis is rare in healthy gingival pockets [5]. The presence of E. gingivalis may suggest some immune deficiency. In this case, detection of E. gingivalis by brush cytology and blood examination revealed immune deficiency. If malignancy or immune deficiency is expected, these two methods are considerable in early stage.

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