Summary
Definition
History and exam
Key diagnostic factors
- erythema or ulceration of oral mucosa
- oral pain
Other diagnostic factors
- dietary impairment
- diarrhea
- fever
Risk factors
- intensive chemotherapy regimens
- radiation therapy to the oral cavity
- chemoradiation
- genetic polymorphisms in drug metabolic enzymes
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- CBC and differential
- blood cultures
- superficial smear of lesion for microscopy
- fungal culture
- viral culture or polymerase chain reaction (PCR)
Treatment algorithm
undergoing hematopoietic stem cell transplant: preventive measures
receiving bolus fluorouracil: preventive measures
receiving radiation therapy to oral cavity: preventive measures
established oral mucositis
Contributors
Authors
Rajesh V. Lalla, DDS, PhD, DABOM
Associate Professor
Associate Dean for Research
Section of Oral Medicine
University of Connecticut School of Dental Medicine
Farmington
CT
Disclosures
RVL serves as a consultant for Galera Therapeutics, Ingalfarma, Mundipharma and Sucampo Pharma, and has received research funding from Onxeo, Sucampo Pharma, Galera Therapeutics and Novartis.
Ourania Nicolatou-Galitis, DDS, MSc, DrDent
Professor
Hospital Dentistry
National & Kapodistrian University of Athens
Athens
Greece
Disclosures
ONG has received fees from Angelini pharma to author a review article on oral mucositis. ONG is an author of several references cited in this topic.
Nikolaos Tsoukalas, MD, MSc, PhD
Medical Oncologist
Associate Director
Department of Oncology
401 General Military Hospital
Athens
Greece
Disclosures
NT declares that he has no competing interests.
Acknowledgements
Professor Ourania Nicolatou-Galitis and Dr Nikolaos Tsoukalas would like to gratefully acknowledge Dr Eleni Arvanitou, who contributed to the updating of this topic, and Dr Rajesh V. Lalla, a previous contributor.
Disclosures
EA declares that she has no competing interests. RVL serves as a consultant for Galera Therapeutics, Ingalfarma, Mundipharma and Sucampo Pharma, and has received research funding from Onxeo, Sucampo Pharma, Galera Therapeutics, and Novartis.
Peer reviewers
Michael Brennan, DDS, MHS
Associate Chairman and Oral Medicine Residency Director
Department of Oral Medicine
Carolinas Medical Center
Charlotte
NC
Disclosures
MB is an author of a reference cited in this topic. MB is part of the Mucositis Study Group of MASCC/ISOO, and participated in the review of mucositis.
Maria Michelagnoli, MB ChB, MD, FRCPCH
Consultant Pediatric and Adolescent Oncologist
University College London Hospitals
London
UK
Disclosures
MM declares that she has no competing interests.
Differentials
- Oral candidiasis
- Herpes simplex virus infection
- Graft-versus-host disease
More DifferentialsGuidelines
- Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation
- MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy
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