Identification of Candida colliculosa in an oral ulcer of a pediatric hematological patient

Introduction:Candida colliculosa is a yeast of food origin classified as Non-Albicans Candida (NAC), with its pathogenic potential confirmed, but little known. Like other opportunistic infections, diseases caused by NAC species are most commonly found in immunosuppressed patients. Objectives: The objective of this work is to report the case of a pediatric patient who developed an atypical lesion associated with Candida collicu-losa in the mouth. Case report: A 9-year-old boy under chemotherapeutic treatment for Acute Myeloid Leukemia developed edema in the lower lip, with a persistent crusted ulcer circumscribed by an erythematous, painless, and progressing negatively. He was using antibiotics, antifungals, antiemetics, and antihistamines. Results: It was decided to perform complementary exams for final diagnosis. Cell smears were collected for exfolia-tive cytology, direct mycological, bacterial and viral culture, and fungi investigation. No viruses and bacteria were identified. A direct mycological examination showed yeast cells without pseudohyphae and a Maldi-TOF technique confirmed the diagnosis of Candida colliculosa. Final considerations: The use of antifungal agents associated with the patient's immunological recovery led to the complete healing of the lesion and hospital discharge. Identification of the fungal species was important not only to establish the diagnosis and most appropriate treatment but also to avoid the fungus spreading in the hospital environment. (AU)

Lingual amyloidosis associated to multiple myeloma: case report / Amiloidose lingual associada a mieloma múltiplo: relato de caso

ABSTRACT Oral amyloidosis is a disease characterized by extracellular and irreversible deposition of amorphous and fibrillar proteins in the oral cavity, being strongly associated with Multiple Myeloma. The objective of this study is to report a case of a 62-year-old woman diagnosed with Multiple Myeloma who, approximately 2 years after starting treatment for the underlying disease, presented a lesion on the lateral border of the tongue with exophytic growth, pinkish color, vascularized, painless, measuring 3cm in its largest diameter. After histopathological analysis through incisional biopsy, a final diagnosis of amyloidosis was obtained. As a local treatment, we opted for complete excision of the lesion. The patient evolved to death due to Multiple Myeloma influenced by the diagnosis of systemic amyloidosis. Oral amyloidosis is usually associated with the systemic presentation of the disease, making it necessary to conduct a thorough investigation of other organs. Its diagnosis is important since the prognosis is directly related and can negatively influence survival rates and treatment of the underlying disease.

RESUMO A amiloidose oral é uma doença caracterizada pela deposição extracelular e irreversível de proteínas amorfas e fibrilares na cavidade bucal, sendo fortemente associada com Mieloma Múltiplo. O objetivo deste trabalho é relatar o caso de uma mulher com 62 anos de idade diagnosticada com Mieloma Múltiplo que, aproximadamente 2 anos após o início do tratamento para a doença de base, apresentou lesão em borda lateral de língua com crescimento exofítico, de coloração rósea, vascularizada, indolor, medindo 3 cm em seu maior diâmetro. Após análise histopatológica através de biópsia incisional, obteve-se diagnóstico final de amiloidose. Como tratamento local, optou-se pela exérese completa da lesão. A paciente evoluiu para óbito por consequência do Mieloma Múltiplo com complicações associadas à amiloidose sistêmica. A amiloidose oral geralmente está associada com a apresentação sistêmica da doença, tornando necessária uma investigação aprofundada nos demais órgãos. Seu diagnóstico é importante uma vez que pode influenciar diretamente no prognóstico e, consequentemente, negativamente nas taxas de sobrevida e no tratamento da doença de base.