Periodontitis in a patient with chronic neutropenia

The aim of this investigation was to obtain information about the composition and the morphology of the microorganisms that inhabit the root surface of a patient with chronic neutropenia and severe and progressive periodontitis. In addition, gingival biopsies were studied by both scanning and transmission electron microscopy (SEM and TEM) to look for bacteria within the gingiva. Dark field microscopy (DFM) revealed 50% spirochetes, 30% motile rods, and 20% coccoid forms. Fourteen extracted teeth studied by SEM showed that the distribution of different bacterial morphotypes varies along the root surface and spirochetes are the prevailing bacteria on the most apically located plaque. TEM analyses of gingival tissue revealed no bacterial invasion within the gingiva. This study suggests that spirochetes may play an important role in the etiology of periodontitis associated with chronic neutropenia. In spite of neutropenic status, there was no bacterial invasion into the gingiva, suggesting that host reaction to dental plaque has not been abolished in this condition.