Trichomonas spp. an etiological factor in the pathogenesis of oral disorders in immunosuppressed patients �

TANA LORENA; CORREA FERNANDO; CACHAU MARÍA VICTORIA ; FERNANDEZ SOLARI JAVIER; DMYTRENKO GANNA ; ZAROUBINA ANGUELINA ; DE LAURENTIIS ANDREA

Bueno Aires

Congreso; Reunión Anual de las Sociedades de Biociencia; 2020

SAIC

Mucosal ulcerations are an oral complication that can often affect immunosupressed patients and adequate treatment depends on the correct determining of its etiology.The diagnosis covers drug-induced ulcers, fungal infections, viruses, as well as opportunistic infection by other microorganisms. Parasitic infection in the oral cavity has not been well studied and it is thought to be underreported. Here we present a case report of an oral lesion present in a kidney transplanted patient. The presumptive diagnosis: drug-induced ulcers, CMV or EBV lesions or ulcers caused by mycosis. Toxic effect of medication was discarded due to the minimal dose administered.The biopsy showed non-specific ulcers with a fibrinoleukocyte layer, lymphoplasmacytic infiltration with diffused neutrophils and eosinophils. Ziehl Neelsen, Giemsa and immunostaining for CMV did not show positive results for any specific microorganisms. EBV was also discarded. The sample from the swab test showed Streptococcus viridians and normal oral microbiota. Direct microscopic observation of moist sample showed a motile pyriform protozoon with flagellar movements compatible with Trichomonas spp. Trichomonas tenax was a variant of T. vaginalis that developed genotypic changes and acquired a phenotype suitable to the ecosystem of the oral cavity. It was isolated from periodontal pockets and expressed proteinases that could disrupt the host tissue integrity promoting oral tissue destruction.Although it is not possible to identify the strain of Trichomonas nor to prove causality between the presence of the protozoan and the development of oral ulceration in our patient, the clinical response to treatment and the absence of other pathogens indicates that this parasite was likely acting as a pathogen. In conclusion, this is the first case that highlights the possibility that Trichomonas spp. should be considered as a potential etiological factor in the pathogenesis of oral disorders in immunosuppressed patients.