Forum for Clinical and Surgical Oral Pathology

Case BBOPF 04-8

The following case was contributed by Dr. Robert Howell (West Virginia University, Morgantown, West Virginia, USA) Dr. Howell invites your diagnosis and comments about the ensuing case. Please send your comments in the window located below the images. This case was posted from October 26 to November 7, 2004. A summary of the responses will be posted in BBOP.

Clinical History

23 year old female who presented to the ER on Sunday (Oct 17th) with a complaint of oral pain and a slight fever (not specified). Some gingival inflammation was noted and a prescription for penicillin (oral) was given. The patient was referred to the dental clinic the following morning (Monday the 18th). The patient was examined and inflammation was noted on the facial gingiva of teeth numbers 24 & 25. The oral temperature was normal but the patient was not able to maintain her oral hygiene and local irrigation was done. The patient put on Peridex irrigation. On, October 20th, the photos show the extension of the disease. It now involves all the mandibular gingiva and about 1/3 of the maxillary gingiva, mainly on the facial but lingual lesions are noted also. A quick review of the medical history reveal a diagnosis for vasculitis in her legs (type unknown by the patient). Cultures were taken (no results yet). White cell count was 17,000 with no abnormal variants noted.

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Case prepared by Dr. Alfredo Aguirre (BBOP Manager) and Daniel Emmer (Web Administrator, University at Buffalo School of Dental Medicine).