Oral mucositis is a common clinical finding in patients undergoing chemotherapy and chemoradiotherapy and is especially common in patients who receive radiation therapy for tumors of the head and neck. Mild mucositis presents as erythematous, atrophic lesions in which the mucosa remains intact. Severe mucositis presents as ulcerative lesions penetrating fully into the submucosa causing severe pain. Although a variety of therapies have been evaluated with regard to mucositis, studies have shown that there is no universally effective method of treatment or prophylaxis. What seems to be clear, however, is that in patients with severe, ulcerative mucositis, there is a population shift in oral microbial flora, which has been poorly described to date. This shift, coupled to the breached mucosal surface, provides a potential route for bacteremia. Other complications of bacterial colonization could potentially include increased cytokine production and resulting tissue damage as a consequence of bacterial cell wall products in the area of the ulcers.3 To characterize the bacterial populations associated with mucositis, broad-range 16s rDNA PCR was performed on oral swab samples from patients with oral mucositis (n = 4). Ongoing data analysis seems to show a trend toward species diversity both within and between individual subjects with mucositis.
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