Cytomegalovirus infection - Oral Mucosal Lesion
Involvement of the oral cavity is rare, ulcers being the most frequent manifestation of CMV infection of the gastrointestinal tract. Infrequently, CMV can cause periodontitis, gingival hyperplasia, and sialadenitis in the oral cavity.
Patients often have concomitant infection of the gastrointestinal tract (bloody diarrhea) and/or the eyes (chorioretinitis). Other symptoms include lymphadenopathy, hepatosplenomegaly, esophagitis, pneumonia, and meningoencephalitis. Transmission is by body secretions, including saliva, blood, urine, breast milk, semen, and cervical fluid.
In one case report, an immunocompromised patient had an oral ulcer that was simultaneously infected by CMV, herpes simplex virus, and Epstein-Barr virus. The pathogenesis of coinfected ulcers is unknown, but it is thought that these human herpesviruses may potentiate each other.
With the advent of antiretroviral therapy (ART), this oral infection has been on the decline in the United States.
Related topics: cytomegalovirus infection of newborn, cytomegalovirus retinitis
B25.9 – Cytomegaloviral disease, unspecified
28944009 – Cytomegalovirus infection
Differential Diagnosis & Pitfalls
- Oral recrudescent herpes simplex virus (HSV) – distinguished by culture or biopsy
- Recurrent aphthous ulcers of the major type – are indistinguishable except that a biopsy would be nonspecific
- Tuberculosis – may appear similar and is distinguished by biopsy
- Non-Hodgkin lymphoma – usually appears as a fleshy mass but may be primarily ulcerated; distinguished by biopsy
- Squamous cell carcinoma – distinguished by biopsy
- Deep fungal infection – distinguished by biopsy
Drug Reaction Data