Unexpected Acute Necrotizing Ulserative Gingivitis in HIV/AIDS Infected Case

Objectives: A male patient, 37 years old, came to the Polyclinic of Oral Medicine, the Department of Dental and Oral Medicine, the Navy Hospital Dr. Ramelan with the main complaint is sore mouth accompanied by spontaneous bleeding in the gums and pain, so the patient feels difficult to eat. This causes the patient's general condition to be very weak. Patients claim to have no history of any disease. Extra Oral examination in the sub mandibular gland area it is found palpable, soft and painful. Patients also have difficulty opening their mouths, accompanied by bad breath. Intra Oral examination on ginggiva regional margin 13 ulcer accompanied by spontaneous bleeding, reddish color, clear borders, irregular edges, it feels very painful.
Methods: Acute necrotizing ulcerative gingivitis (ANUG) is a periodontal disease, the main features of which are infection and inflammation of the periodontal tissues. ANUG is characterized by marginal gingival necrosis, gingival bleeding and painful ulceration of the gingival surface. ANUG is caused by periodontopathic bacteria. As ANUG progresses, extensive bone loss can develop, so this is a serious and notable disease. In human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) patients, oral lesions are important because they are easily observed with the naked eye and can represent the first clinical signs of diseases. The prevalence of necrotizing gingivitis varies, but previous studies have suggested rates from 0% to 6.3% in HIV/AIDS patients. Furthermore, ANUG has been correlated with CD4+ T-lymphocyte counts below 200 cells/μL. This indicates that physicians can speculate on CD4+ T-lymphocyte counts from the presence of ANUG, and vice versa. The purpose of writing this case report is to report on the multidisciplinary management of ANUG cases as a manifestation of HIV / AIDS infection in the Dr. Ramelan Surabaya. This case is expected to provide an overview to health workers, especially dentists, regarding infections that can occur in patients with HIV / AIDS.
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