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The impact of oral herpes simplex virus infection and candidiasis on chemotherapy-induced oral mucositis among patients with hematological malignancies

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Abstract

The aim of this study was to evaluate the influences of oral candidiasis and herpes simplex virus 1 (HSV-1) infections in chemotherapy-induced oral mucositis (OM). The medical records of 424 consecutive patients with hematological malignancies who had received chemotherapy at a medical center in Taiwan from January 2006 to November 2007 were retrospectively reviewed. The results of swab cultures of fungus and HSV-1 for OM were correlated with associated clinical features. Younger age, myeloid malignancies, and disease status other than complete remission before chemotherapy were significantly correlated with the development of OM. Risks of fever (p <0.001) and bacteremia were higher in patients with OM. Among 467 episodes of OM with both swab cultures available, 221 were non-infection (47.3%) and 246 were related to either fungal infections, HSV-1 infections, or both (52.7%); of the 246 episodes, 102 were associated with fungal infections alone (21.8%), 98 with HSV-1 infections alone (21%), and 46 with both infections (9.9%). Patients who had received antifungal agents prior to OM occurrence tended to have HSV-1 infection (p <0.001). Our results suggest that Candida albicans and HSV-1 play an important role in chemotherapy-induced OM in patients with hematological malignancies.

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Acknowledgments

We thank Jih-Luh Tang, Ming Yao, Wen-Chien Chou, Shang-Yi Huang, Bor-Sheng Ko, Szu-Chun Hsu, Chien-Yuan Chen, and Woei Tsay (National Taiwan University Hospital) for providing the study materials or clinical information of the patients.

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The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    Y.-K. Chen

  2. Department of Internal Medicine, Taipei Municipal Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Y.-K. Chen & J.-M. Chow

  3. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

    H.-A. Hou, Y.-C. Chen, P.-R. Hsueh & H.-F. Tien

Authors
  1. Y.-K. Chen
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  2. H.-A. Hou
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  3. J.-M. Chow
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  4. Y.-C. Chen
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  5. P.-R. Hsueh
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  6. H.-F. Tien
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Corresponding authors

Correspondence to P.-R. Hsueh or H.-F. Tien.

Additional information

Part of the data have been presented at the 12th Congress of the European Hematology Association (EHA), Vienna, Austria, 7–10 June 2007.

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Chen, YK., Hou, HA., Chow, JM. et al. The impact of oral herpes simplex virus infection and candidiasis on chemotherapy-induced oral mucositis among patients with hematological malignancies. Eur J Clin Microbiol Infect Dis 30, 753–759 (2011). https://doi.org/10.1007/s10096-010-1148-z

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  • DOI: https://doi.org/10.1007/s10096-010-1148-z

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