Severe Presentation of Necrotizing Ulcerative Periodontitis in a Nigerian HIV-Positive Patient: A Case Report

Objective: To report a case of severe necrotizing ulcerative periodontitis (NUP) with a rarely associated sequestrum formation in a Nigerian HIV-positive patient. Clinical Presentation and Intervention: A 47-year-old HIV-positive male patient with no history of previous dental visits presented with a severe toothache in his lower jaw of 4 weeks’ duration, which had affected his ability to chew properly. Clinical examination revealed marked gingival inflammation, moderate gingival recession and mobility of some of his lower anterior teeth: 31, 32, and 33. There was also a sequestrum present associated with the affected teeth. His CD4 cell count was 226 cells/mm 3 . His viral load was very high (360,082 copies/ml). The intervention included thorough debridement of the necrotic lesion and sequestrectomy. The patient responded well to treatment after 1 week of follow-up. Unfortunately, the CD4 count was not assessed further because the patient was lost to follow-up. Conclusion: This case showed that a high CD4 cell count does not necessarily prevent the occurrence of NUP in HIV-positive patients. Intervention might have enhanced a rapid positive response to the treatment within a short time. Copyright © 2011 S. Karger AG, Basel Received: June 14, 2010 Accepted: November 8, 2010 Dr. Kehinde Adesola Umeizudike Department of Preventive Dentistry, Faculty of Dental Sciences College of Medicine, University of Lagos P.M.B. 12003, Lagos (Nigeria) Tel. +234 805 545 1018, E-Mail kumeiz09 @ gmail.com © 2011 S. Karger AG, Basel 1011–7571/11/0204–0374$38.00/0 Accessible online at: www.karger.com/mpp D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /1 9/ 20 17 2 :2 6: 04 P M