A 54-year-old man, a nonsmoker, has a nonhealing ulceration at the base of his tongue on the right side for 2 months. On examination this lesion is 1 cm in diameter with irregular borders. Biopsy of the lesion is performed and microscopic examination shows infiltrating squamous cell carcinoma. Which of the following infectious agents is most likely to be associated with this lesion?
Smoking and alcoholism are frequent etiologies for oral squamous cell carcinomas, and mutations in the TP53 gene are often present. However, in nonsmokers, HPV infection may be implicated, along with overexpression of p16. The good news: the oral carcinomas arising with HPV have a better prognosis, though they may be multifocal and recur. The better news: vaccination against HPV may help prevent this disease. Oral candidiasis (thrush) may occur in immunocompromised persons. HSV causes self-limited acute gingivostomatitis (cold sores). The genus Prevotella includes anaerobes that are associated with periodontitis and with buccal infections that become cellulitis (Ludwig angina). Strep throat is an acute exudative pharyngitis that has the immunologic complications of rheumatic heart disease or postinfectious glomerulonephritis.
Candida albicans
Herpes simplex virus (HSV)
Human papillomavirus (HPV)
Prevotella intermedia
Head & Neck