RAPID PROGRESSION OF BONE LOSS IN HIV-ASSOCIATED NECROTIZING ULCERATIVE STOMATITIS

THIS REPORT DESCRIBES A CASE Of rapidly progressive periodontal tissue breakdown and bone loss in an HPV-infected markedly immunosuppressed homosexual male. Within 6 months of initial presentation with a necrot izing ulcerative gingivitis, the lesion extended to a necrotizing ulce rative stomatitis involving the surrounding periodontium and palatal m ucosa. With only partial compliance to local debridement, chlorhexidin e oral rinses, and systemic metronidazole therapy, alveolar bone loss resulted in tooth mobility necessitating extraction of 2 involved teet h. This case illustrates the continuum of necrotizing ulcerative infec tions of the periodontium in the severely immunosuppressed patient. Th e implications of these oral manifestations of HIV infection are discu ssed.