Orofacial manifestations from accidental exposure to caesium 137 in Goiania, Brazil.

The accidental close exposure of over 200 adults and children to a caesium-137 (137Cs) source in Goiania, Brazil in 1987 produced significant short-term morbidity in about 50 patients, and four deaths within a few weeks. Some 57% of those maximally exposed to radiation, developed orofacial lesions, notably purpura, spontaneous bleeding, ulcers and/or acute candidiasis. These lesions were probably mainly the consequences of depression of bone marrow elements by the radionuclide. Though the oral lesions that may follow iatrogenic exposure to ionizing radiation are well recognized this appears to be the first report on the oral sequelae of a serious radiation accident.