What are the symptoms of endocarditis?

Oral endocarditis is a common oral disease. If not treated in time, it will cause pus and ulceration in the wound, so timely treatment is required. The symptoms of oral endocarditis are pain in the oral lining. If the situation is serious, the patient will also feel severe pain when eating. These are easy-to-find symptoms of the disease.

1. Primary oral endocarditis caused by anticancer drugs

Since primary oral endocarditis caused by anticancer drugs is based on the production of free radicals by damaged oral mucosa, its prevention should focus on controlling the production of free radicals. It is believed that the use of free radical inhibitors such as allopurinol, carmustine and fumetabolic steroids, which have similar effects, is effective. Other methods include blocking anticancer drugs from reaching the portal mucosa.

(1) Cooling therapy: Cooling therapy is a method of cooling the oral cavity to shrink the blood vessels in the oral mucosa, thereby reducing the amount of anticancer drugs that can reach the oral cavity.

Intraoral mucosal approach. Some people have reported that this method can achieve good results in preventing oral endocarditis during calcium leucovorin/fluazide chemotherapy.

(2) Gargling with allopurin to prevent oral endothelitis: The metabolite of allopurinol can inhibit a key enzyme in pyrimidine synthesis (ororidylate decarbolylate), reduce the conversion of fluorouracil to 5-dUMP and the formation of FUTP (flurouridine triphosphate), and antagonize the anti-tumor activity and toxicity of fluorouracil. It has been reported that the use of allopurinol mouthwash can reduce the incidence of oral endocarditis in the vincristine/fluorouracil regimen or fluorouracil/cisplatin regimen from 14/15 to 4/15.

(3) There are few reports on oral endothelial inflammation caused by Fuyipan, but camostat is a strong free radical inhibitor. Therefore, Fuyipan, which has the same effect as camostat, can be tried to prevent oral endothelial inflammation. The specific preparation method and usage of Fuyipan are as follows: add 1000mg of Fuyipan, 5g of sodium carboxycellulose, 50ml of syrup, and appropriate amount of flavoring, and adjust to 500ml with water. Gargle 12 ml for 30 minutes 4 times a day, then rinse with 100 ml of liquid containing 2 g of sodium bicarbonate, using the same method as after gargling with allopurinol.

2. Treatment measures for secondary oral endocarditis

Secondary oral endocarditis caused by anticancer drugs is often secondary to local infection under conditions such as decreased white blood cell count and low immune function. The following methods can reduce the symptoms of secondary endocarditis.

(1) Keep the oral cavity clean. Rinse the mouth regularly with povidone-iodine or other products.

(2) Maintain the white blood cell count within the normal range: Use G-CSF when necessary to maintain the white blood cell count within the normal range. Cabriob et al. reported that the use of G-CSF can reduce the occurrence of oral endocarditis when using the methotrexate/vinblastine/doxorubicin/cisplatin chemotherapy regimen.

(3) Application of antibiotics and antifungal drugs: While treating the symptoms of fever cases, oral mucosal secretions should be cultured for bacteria and fungi, and sensitive antibiotics and antifungal drugs should be selected for treatment.