Department of Infectious Diseases, St. Jude Children's Research Hospital, University of Tennessee Health Science Center, Memphis, TN 38105, USA. Isao.Miyairi@stjude.org
An 8-year-old girl with leukemia developed acute necrotizing ulcerative gingivitis with Stenotrophomonas maltophilia and herpes simplex virus. Progression to bacteremia with pathologic evidence of osteomyelitis occurred despite appropriate antimicrobial therapy. This case highlights the importance of prompt recognition, debridement and appropriate therapy in immunocompromised patients with acute necrotizing ulcerative gingivitis.