The use of antimicrobial photodynamic therapy in oral injuries of a pediatric patient with myelodysplastic syndrome: case report

• Published in: Special care in dentistry Vol. 38; no. 2; pp. 95 - 98
• Main Authors: Melo, Maria Cecília Freire, Silva de Macedo, Thuanny, Biserra, Julianelly Alves, Rodrigues, Karina Luz Cavalcanti, Cruz, Mônica, Vidal, Aurora Karla de Lacerda
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-03-2018
• Subjects: Anti-Bacterial Agents - therapeutic use; Antimicrobial agents; Bacterial Infections - drug therapy; Bacterial Infections - microbiology; Case reports; Dentistry; Fatal Outcome; Gingival Diseases - drug therapy; Gingival Diseases - microbiology; hematology; hospital dentistry; Humans; Infant; Infectious diseases; Male; Methylene blue; Methylene Blue - therapeutic use; Myelodysplastic syndrome; Myelodysplastic syndromes; Myelodysplastic Syndromes - complications; pediatric dentistry; Pediatrics; Photochemotherapy - methods; Photodynamic therapy; Photosensitization; Photosensitizing Agents - therapeutic use; Quality of life; Teeth; hematology; pediatric dentistry; hospital dentistry
• ISSN: 0275-1879; 1754-4505
• DOI: 10.1111/scd.12275

ABSTRACT
Aim
To report a case of a pediatric patient carrier of myelodysplastic syndrome (MDS) with severe oral infectious disease, in which antimicrobial photodynamic therapy (aPDT) was used as a therapeutic choice to support systemic treatment.
Methods and Results
This case report refers to a 1‐year‐old male patient with MDS and hospitalized for investigation and treatment of complications at a Pediatric Oncology and Hematology Center in Recife/PE, Brazil. The intraoral examination revealed a violaceous lesion surrounding the lower incisor teeth, which progressed with alteration of color to milky yellowish white, compromising the entire lower gingival border, leading to tooth mobility and consequent loss of teeth 71 and 81. The patient was treated under systemic antimicrobial therapy and aPDT was also performed, using a photosensitizing agent (methylene blue, 0.01%) and a low‐intensity laser in the visible red spectrum. Oral clinical improvement was observed, but the patient died after 45 days of hospitalization in the Pediatric ICU due to other systemic complications.
Conclusion
MDS may present limiting oral repercussions interfering in patients’ quality of life. The aPDT is presented as an adjuvant therapeutic modality in oral infections with satisfactory results.