ORAL MANIFESTATIONS OF VIRAL INFECTIONS IN IMMUNOCOMPROMISED CANCER PATIENTS

Abstract

Immunodeficiencies induced by chemotherapy make cancer patients vulnerable to to reactivation of latent viruses and to primary viral infections caused by exposure to environmental factors, such as air, water, microbial flora and debris. Patients with hematological cancers are more prone than patients with solid tumors to develop viral infections that affect the oral cavity due to high-dose chemotherapy regimens and prolonged immunosuppression. Viruses of the Herpetoviridae family (herpes simplex, varicella, cytomegalovirus, Epstein-Barr) and human papillomavirus cause mouth pain with difficulties in eating and oral ulcerations that can spread, leading to life-threatening systemic infection. Therapeutic approaches for the more severe and atypical oral manifestations seen in cancer immunosuppressed patients include inhibitors of virus replication, antivirals, surgical excision and analgesics, but the painful oral lesions are associated with longer healing times. The differential diagnosis of a oral ulcers in cancer patients is broad, but it should include various viral infections.

Keywords

• viral infection
• immunosuppression
• cancer chemotherapy
• oral lesions
• mucositis