The multiple protective-barrier functions associated with normal
oral mucosa directly affect risk of acute infection. Normal oral
mucosa reduces levels of oral microorganisms colonizing the
mucosa by shedding the surface layer; it also limits penetration
of many compounds into the epithelium by maintaining a chemical
barrier. Normal salivary gland function promotes mucosal health.
Oral mucositis can be complicated by infection in the
immunocompromised patient. Specific organisms may play a role in
upregulating proinflammatory cytokines via bacterial metabolic
products such as liposaccharides. Also, oral organisms can
disseminate systemically in the setting of ulcerative oral
mucositis and profound, prolonged neutropenia.[2-5] Both
indigenous oral flora and hospital-acquired pathogens have been
associated with bacteremias and systemic infection. As the
absolute neutrophil count falls below 1,000/mm3, incidence and
severity of infection rise. Patients with prolonged neutropenia
are at higher risk of developing