UNUSUAL CAUSE OF PALATAL ULCER IN A PARTIAL DENTURE WEARER: ALCALIGENES SPECIES

Palatal dentures are known to predispose wearers to developing opportunistic bacterial and fungi infections. This study reports a rare case of palatal ulceration associated with Alcaligenes species infection in a patient using an upper single tooth partial denture, to emphasize the need for proper care of dentures to prevent opportunistic infection. A 30 years old civil servant presented with a 6-day history of sore in the roof of the mouth associated with pain, difficulty with mouth opening, chewing and swallowing. The patient had tooth extraction followed by an upper single tooth partial denture inserted about 2 years before he presented with the complaint of palatal sore. Oral examination revealed a solitary, oval shaped, tender, palatal ulcer, with erythematous floor and some yellowish areas of necrotic sloughs, and located distal to the upper single tooth partial denture. There was no submandibular lymph node enlargement. HIV screening (ELISA) showed that the patient was HIV negative and VDRL screening for syphilis was also negative. Microscopy culture and sensitivity (MCS) of the palatal ulcer yielded growth of Alcaligenes species that was sensitive to erythromycin. A diagnosis of palatal ulcer associated with Alcaligenes species was made and the patient was placed on Tabs Erythromycin 500mg 8 hourly and Flagyl 400mg 8 hourly for a week, and warm saline mouth rinse 6 times daily for 2 weeks. The palatal ulcer was completely healed in less than 3 weeks after presentation. This study supports proper education of denture wearers on how to care for their dentures. Six monthly visits to dental clinic is recommended for review of the status of denture and the underlying oral mucosal, to prevent opportunistic infection and ensure better quality of life for denture wearers.