Oral Manifestation of Cytomegalovirus Associated With Herpes Simplex Virus in Renal Transplant Recipient

We report a case of a renal transplant recipient who presented with oral lesions associated with cytomegalovirus (CMV) and herpes simplex virus (HSV). This female patient, who underwent a living donor renal transplant 26 months prior, presented with a painful buccal lesion after an episode of leukopenia. The search for CMV antigen was negative. A biopsy incision was made in the mucous membrane and the material collected by scarification was sent for polymerase chain reaction PCR, anatomic, pathological, and cytological exams. The lab results showed infections with CMV, HSV, and Candida albicans. Thus, the treatment involved the use of acyclovir (1 g a day for 10 days), topical Nystatin gargles (six times a day), and an aqueous solution of chlorexidine (0.12%), as well as laser therapy. After the adoption of these therapeutic modalities, there was complete remission of the buccal lesions. The odontological routine follow-up and early treatment of oral complications deriving from the immunosuppressive therapy contributed to a significant outcome.