Also known as moniliasis or thrush or candidosis

Caused by Candida albician

CLASSIFICATION

PREDISPOSING FACTOR

• Change in oral microbial flora

– Administration of antibiotics specially broad spectrum
– Xerostomia secondary to anticholinergic agents
– Salivary gland disease

• Local Irritation

– Denture, orthodontic appliance
– Heavy smoking

• Drug therapy

– Corticosteroid or cyto-toxic drug or immunosuppressive drug
– Radiation therapy

• Other systemic disease

– Leukemia
– Lymphoma
– Diabetes
– Tuberculosis
– Epithelial dysplesia

• Malnutrition status

– Low serum vit A
– Pyridoxine
– Iron level

• Age

– Infancy
– Pregnancy
– Old age

• Endocrine deficiency

– Hypoparathyroidism
– Hypothyroidism
– Addison’s disease

• Others

– Tight fitting garments
– Indwelling catheter

PSEUDOMEMBRANOUS CANDIDIASIS

• Thrush
• Superficial infection of upper layer of oral mucous membrane
• Fungal growth – desquamation of epithelial cell and accumaltion of bacteria, keratin and necrotic tissue forming pseudomembrane

Clinical features:

Infants

• 6th and 10th day after birth
• Infection from maternal vaginal canal
• Soft white/bluish whit, adherent patches on oral mucos
• Painless
• Removed with little difficulty

Adult

– Site : roof of mouth, retromolar area, Mucobuccal fold
– Sex: female
– Prodromal symptom : rapid onset of bad taste and discomfort from spicy food
– Burnig sensation
– White plaque

• pearly white or bluish white – resemble cottage cheese or curdled milk
• Composed of tangled mass of hyphae, yeast, desquamated epithelial cell and debris
• Easily wiped out – erythematous/atrophic area which is painful

ACUTE ATROPHIC CANDIDIASIS

• Antibiotics sore mouth
• Any site but mainly involves tongue or area facing prosthesis
• Red or erythematous
• Vague pain or burning sensation
• Careful examination – white thickened foci that can be rubbed off

CHRONIC HYPERPLASTIC CANDIDIASIS

• Candidal leukoplakia
• Persist without any pain for years
• Doesn’t rubs off with lateral pressure
• Slightly white to dense white with cracks and fissures occasionally
• Vague border – epithelial dysplasia

CHRONIC ATROPHIC CANDIDIASIS

• Also known as Denture stomatitis
• Bright red palatal tissue – edematous and granular
• Sharply outline of redness
• Multiple pinpoint foci of hyperemia usually involving the maxilla

ID REACTION

• Secondary response characterized by localized or generalized sterile vesicopapular rash that is believed to be allergic response – candida antigen (monoloids)

TREATMENT OF ORAL CANDIDIASIS

• Topically or systematic
• 7 days treatment
• Oral symptoms disappears in 2-5 days
• Relapse common – underlying immunodeficiency
• Removal of causative factors – Ill fitting denture – Withdrawal or change of antibiotics – Proper cleaning of denture and use of antifungal agent

Topical treatment:Clotrimazole,1% genitian violet, Nystatin, Amphotericin, Mycostatin cream , Idoquinol

Systemic Treatment:Nystatin,Ketaconazole ,Itraconazole,Fluconazole

MCQs

1. Candidiasis associated with Dentures is_______?
2. Acute Pseudo Membranous
3. Acute Atrophic
4. Chronic Hyperplastic
5. Chonic atrophic

Answer: D

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Click here to view QA and Description for Candidiasis