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Abstract
Cytomegalovirus (CMV) infection presenting as a painful palatal gingival ulcer was
one of the initial clinical manifestations of the acquired immune deficiency syndrome
(AIDS) in a male homosexual patient. The diagnosis of oral CMV infection was established
when large intranuclear and smaller cytoplasmic CMV inclusions were observed in endothelial
cells at the base of the mucosal ulcer. The identification of intranuclear and intracytoplasmic
herpes-type viral particles in the infected cells was confirmed by electron microscopy.
Cytoplasmic viral particles coexisted with paranuclear dense bodies resembling lysosomes.
These features are characteristic of CMV-infected cells. A review of the Engish-language
literature disclosed only three previously reported cases of CMV infection involving
the oral mucous membranes. A vasculitis associated with the CMV-infected endothelial
cells appears to be the underlying mechanism responsible for development of the oral
ulcer. CMV should be considered a possible causative agent when oral ulcers are detected
in immunocompromised patients. Likewise, the finding of CMV in oral ulcers should
alert one to the possibility of an immunocompromised state.
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© 1987 Published by Elsevier Inc.
