Oral Mucosal Persistent and Short Term Ulcers in HIV Infection 口腔粘膜的持久性和短在HIV感染长期溃疡.ppt

Oral Manifestations of Pediatric HIV Infection: Clinical Characteristics, Diagnosis, Treatment Recommendations and Disease Significance Disease Pattern Differences in Pediatric and Adult HIV Infection Narrower spectrum of infectious diseases in children More vulnerable to recurrent bacterial infections More susceptible to central nervous system disorders Increased risk for HIV-lymphoproliferation Decreased risk for malignancies Endocrine and metabolic impact on growth and development Behavioral and emotional problems due to chronic illness Diagnosis of Pediatric HIV Oral Lesions Clinical examination is important because history is often unknown or incomplete Rely on noninvasive procedures for initial diagnosis and treatment Treatment often requires modification and individual customization Successful management necessitates care giver involvement and understanding Diagnosis should be re-evaluated, if treatment is not effective Oral Manifestations of Pediatric HIV Infection Most children will have at least one oral lesion Infectious diseases: bacterial, viral and fungal Most neoplasms are EBV driven: lymphoma, leiomyoma and leiomyosarcoma Immunologic disorders: aphthous ulcers, parotitis, lymphadenopathy, thrombocytopenia and allergic reactions Iatrogenic diseases are caused by drug side effects Dental diseases: Dental caries, enamel hypoplasia, over-retained teeth, delayed eruption of teeth Oral Candidiasis in Children Common opportunistic fungal infection, affecting up to 72% of HIV infected children Cause: Candida species, usually Candida albicans Contributing factors: Immune suppression, xerostomia medications, oral appliances, poor oral hygiene Forms: Pseudomembranous, erythematous hyperplastic candidiasis, angular cheilitis, median rhomboid glossitis, cheilocandidiasis Site: Lips and oropharyngeal mucosa Signs Symptoms: Red or white patches, erosions, burning sensation, sore throat, taste alterations Diagnosis: Clinical findings, culture, cytolog