Successful treatment of persistent oral ulcers in patients with HIV / AIDS

Oral ulceration is a common condition found in patient with HIV/AIDS. The ulcerations may be fungal/bacterial/viral infection-associated or non-infection-associated. The standard treatment protocol for these oral ulcers includes the elimination of etiologic factors, pain reduction, healing acceleration and prevention of recurrent episodes. However, challenges may be applied when dealing with a patient with HIV/AIDS. A 39 years old male with a diagnosis of AIDS, was referred to Oral Medicine Clinic in Cipto Mangunkusumo Hospital. He initially presented with necrotizing stomatitis on the upper lip and tongue. Standard treatment protocol for oral ulcers was done, however due to his anemic condition, the healing was delayed and accompanied with occurrence of another necrotizing stomatitis lesions on the right retromolar pad, on uvula extended to soft palate, and major stomatitis on the posterior lateral of tongue. The management included debridement using antiseptic, application of topical metronidazole as well as improvement of his systemic conditions with a blood transfusion, antiretroviral therapy, and systemic antibiotics. The success of treatment of this case is determined by lesion management, patient's compliance, and improvement of systemic condition that includes improving nutrition intake, therapy of anemia, and correcting CD4 count that was achieved with teamwork of different specialties.