- Acute Necrotizing Ulcerative Gingivitis Anug Is A Severe Condition Distinct From Other Forms Of Periodontitis It Begi 1 (68.24 KiB) Viewed 15 times
What predispoing conditions did the patient in this case have that made him vulnerable to ANUG?
- Acute Necrotizing Ulcerative Gingivitis Anug Is A Severe Condition Distinct From Other Forms Of Periodontitis It Begi 2 (49.01 KiB) Viewed 15 times
What suggests that the patient had a disease and not just an inflammation?
- Acute Necrotizing Ulcerative Gingivitis Anug Is A Severe Condition Distinct From Other Forms Of Periodontitis It Begi 3 (74.84 KiB) Viewed 15 times
Why did the patient take acyclovir?
- Acute Necrotizing Ulcerative Gingivitis Anug Is A Severe Condition Distinct From Other Forms Of Periodontitis It Begi 4 (52.76 KiB) Viewed 15 times
Why was the patient treated with metronidazole, a broad-spectrum antibiotic?
- Acute Necrotizing Ulcerative Gingivitis Anug Is A Severe Condition Distinct From Other Forms Of Periodontitis It Begi 5 (60.76 KiB) Viewed 15 times
How much metronidazole did the patient take in total?
- Acute Necrotizing Ulcerative Gingivitis Anug Is A Severe Condition Distinct From Other Forms Of Periodontitis It Begi 6 (47.04 KiB) Viewed 15 times
Acute necrotizing ulcerative gingivitis (ANUG) is a severe condition distinct from other forms of periodontitis. It begins abruptly and is characterized by bleeding, painful gums that are often ulcerated; necrotic lesions sometimes develop. Some patients also have extremely bad breath and report an unpleasant metallic taste. Fever, malaise and swollen lymph nodes may be present. It is associated with poor oral hygiene, malnutrition, smoking, immunodeficiency, or methamphetamine use. The disease is polymicrobial, and is treated with braod-spectrum antibiotics, along with plaque removal and gum surgery if necessary. A 21-year old patient presented at the Department of Periodontology at the University of Morocco with malaise, fever, chills, and inflamed, painful gingiva. The pain had increased in intensity over a period of 4 days, making it difficult for the patient to eat. He had taken the antiviral drug acyclovir (used to treat oral herpes), and also an anti-inflammatory medication (diclofenac). He reported being in a psychologically stressful job (modeling) and was on a very strict, severe diet. Examination of the patient revealed that he was very thin, and had poor oral hygiene, with plaque formation and halitosis (bad breath). His gingiva were red and swollen, with pseudomembrane formation at the gingival margins; ulcers were also present. X-rays showed some bone loss of the jaw and receding gums. The patient was given an HIV test, which was negative. At this time, he was diagnosed with acute necrotizing ulcerative gingivitis (ANUG). He was immediately treated with application of 10% hydrogen peroxide solution to the ulcerated gingiva, with debridement of any necrotic areas. He was prescribed an oral antibiotic (250 mg metronidazole every 8 hours for 7 days) and an antiseptic oral mouthwash (12% chlorhexidine twice a day for 10 days). The patient was evaluated after 2 days, and then again after 7, at which time he showed considerable improvement: he had almost complete resolution of the pseudomenbranes and ulcerations, and reduction in the swelling and redness. He was seen again on a regular basis thereafter and was found to be compliant with proper oral hygiene practices, and fully recovered. Source: Malek R, Gharibi A, Khlil N, Kissa J. Necrotizing Ulcerative Gingivitis. Contemp Clin Dent. 2017:8(3):496-500. doi:10.4103/ccd.ccd_1181_16
O O O O O He was under psychological stress AND he was on a severe diet He was a smoker AND he used methamphetamines He was HIV-positive AND he was under psychological stress He used methamphetamines AND he was on a severe diet He was HIV-positive AND he was a smoker
O O O O O He was underweight and was immunocompromised. He had red, painful, swollen gums and halitosis. His white blood cell count was elevated. He had fever, chills and malaise. He was taking acyclovir and an anti-inflammatory.
O O O O O He was likely self-medicating. Gingivitis is always treated with antivirals. He was diagnosed with oral herpes. He was HIV-positive. He was prescribed it by his dentist. < Prev 21 23
O O O O ANUG infections are caused by anaerobes and metronidazole is anaerobic. ANUG Infections are caused by aerobes and metronidazole is aerobic. ANUG infections are polymicrobial, involving a variety of bacterial species. Broad-spectrum antibiotics have little impact on a person's intestinal normal microbiota. Metronidazole is the only effective antibiotic for treating ANUG. S < Prev 23 24 Next of 49
о O O O о 5, 250 g 5.25 g 250 mg 2.5 g 250 g < Prev NO 2