Abstract and Introduction
A 58-year-old man named J.S. was diagnosed with non-Hodgkin lymphoma and underwent treatment with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. He presented to his local outpatient clinic for evaluation and laboratory tests on day 10 after cycle 3. During this visit, J.S. reported great difficulty opening his mouth with significant gingival and lingual pain when eating and drinking in spite of prophylactic oral care. Laboratory test results revealed a white blood cell count of 0.9 k/ul, hemoglobin level of 8.9 g/dl, platelets of 100 k/ul, serum creatinine level of 1 mg/dl, and blood urea nitrogen level of 29 mg/dl.
Examination revealed a man in good physical shape with normal vital signs and oxygen saturation level on room air. Although his oral mucosa was pink, his tongue and buccal mucosa had bilateral ulcerations with xerostomia (dry mouth). Upper and lower gingivae were intact but sensitive to touch. The remainder of his physical examination was normal. He was provided with education on continuing oral care, antivirals, analgesics, and neutropenic precautions. He did receive growth factor support 24 hours after completion of therapy. Diagnosis based on clinical presentation was herpes simplex virus (HSV)-related oral mucositis.
Oncol Nurs Forum. 2014;41(3):327-330. © 2014 Oncology Nursing Society
