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We examined 13 cases of primary oral aspergillosis in adult leukemia patients.Although the patients received systemic and local antifungal treatment in laminar air-flow rooms, primary oral aspergillosis generally developed in about 20 days in association with adrop in leukocyte count to under 1, 000/mm3 after chemotherapy. The initially involved area was the marginal gingiva which was associated with necrosis and severe pain. At the same time, spiking fever of about 39°C was observed. Necrotic changes of the gingiva progressed rapidly and invasively extended from the mucosa to muscle and bone. Local aspergillosis basically disappeared when the hematologic status of the patients returned to normal levels under antifungal treatment. The prognosis of primary oral aspergillosis was relatively good. However, damaged oral tissues were easily reinfected with aspergillus during chemotherapy.These findings suggest that oral hygiene plays an important role in the development of oral aspergillosis in adult leukemia patients.

Primary oral aspergillosis in adults with leukemia. Opportunistic infection associated with chemotherapy.