Micronutrient tests performed on Anh at Tam Anh General Hospital TP HCM revealed deficiencies in iron and calcium. Master of Science, Doctor, First-Degree Specialist Vuong Ngoc Thien Thanh of the Pediatrics Department diagnosed the patient with cellulitis, an oral abscess, and mild malnutrition.

Anh received intravenous feeding, along with fluids, pain medication, anti-inflammatory drugs, and antibiotics. Doctors prescribed daily cleaning of the oral ulcers and the application of topical antifungal medication, combined with specific intravenous antibiotics. After 7 days of treatment, the ulcers in her mouth had significantly reduced, her lips and tongue were no longer swollen, and Anh was able to eat and drink normally before being discharged.

Doctor Thanh checks Anh's health before discharge. Photo: Tam Anh General Hospital

Doctor Thanh explained that *Staphylococcus aureus*, commonly known as golden staph, is a bacterium often found on skin and mucous membranes. If the protective barrier of the oral mucosa is compromised, for instance by canker sores or minor abrasions, the bacteria can penetrate deeper, leading to cellulitis and abscess formation. Concurrently, *Candida* fungus, which naturally coexists in the mouth, can proliferate and cause severe infections when the immune system is weakened. The combined action of these two pathogens results in ulcers that are widespread, deep, and challenging to treat without timely and appropriate medical intervention.

Anh's ongoing orthodontic treatment with braces was identified as another risk factor for her oral ulcers. Brackets and archwires can cause minor abrasions on the oral mucosa, creating entry points for bacteria and fungi. This, combined with her mild malnutrition and deficiencies in iron and calcium, significantly weakened her body's natural immune response, making her susceptible to a severe infection, Doctor Thanh noted.

Doctor Thanh advised parents to seek medical attention if their child's oral ulcers persist beyond 7-10 days, show signs of spreading, or are accompanied by fever or swollen lymph nodes. For children undergoing orthodontic treatment, diligent oral hygiene is crucial, including using suitable toothbrushes, rinsing with physiological saline solution, and attending regular dental check-ups. Furthermore, parents must ensure adolescents receive a diet rich in essential micronutrients, particularly iron, calcium, and zinc.

Gian Don

*Character's name has been changed