Oral Candidiasis

Candidiasis commonly affects the oral cavity. Nearly 60 percent of healthy adults harbor candidal microorganisms. Concurrent histologic evidence of tissue invasion and clinical manifestations of candidal infections are the primary means for diagnosing oral candidiasis. Many predisposing factors influence the development of oral candidiasis. These include the extremes of age, intraoral prosthetic devices such as dentures, malnourished states, associated mucosal disorders, concurrent infections, antibiotics, and immunocompromised conditions such as acquired immunodeficiency syndrome (AIDS), transplant recipients, radiation therapy, and chronic immunosuppressive therapy. Three oral clinical types have been described. The most common type is the psuedomembranous type with white, curdlike plaques. These plaques can be easily scraped off to reveal an underlying erythematous mucosal base. The second type is atrophic or erythematous and usually involves the dorsum of the tongue. Atrophy of the filiform papillae is seen. Finally, the lesions of hyperplastic candidiasis are raised white plaques that can only be partially removed with scraping due to deeper infiltration into the underlying tissue. Perioral candidiasis also may occur and is commonly seen as angular cheiltis or scaling patches of the perioral facial tissues. Treatment is with topical oral antifungal agents such as nystatin oral suspension 500,000 units qid or systemic agents such as fluconizole 200 mg bid. 11,15,16

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