Oral Fungal Infections Flashcards
What is oral candidosis?
- Opportunistic fungal infection of the oral cavity
- Rarely itself painful
- “disease of the diseased”
What are the classifications of oral candidosis?
- Pseudomembranous (white); ACUTE
- Erythematous (red); ACUTE
- Hyperplastic (raised & white); CHRONIC
- Other (associated lesions); primarily oral candidosis with other causes
- Angular cheilitis
- Denture stomatitis
- Median rhomboid glossitis
- Linear gingival erythema
What is Newton’s type used to describe?
Chronic denture-induced erythematous candidosis
What are the Newton types?
- Type I = pin point lesions
- Type II = diffuse erythema
- Type III = granular
What fungus is commonly associated with candidosis?
Candida albicans
What structure of blastospores is associated with virulence?
Hyphae (mycelium)
Name some candidal virulence factors
- Adherence
- Switching mechanisms
- Germ tube formation
- Extracellular enzymes
- Acidic metabolites
What local factors predisposes a patient to oral candidal infections?
- AB use
- Dentures (fungal infections adhere well to acrylic)
- Local corticosteroids
- Dry mouth (saliva contains secretory IgA); polypharmacy
What general factors predisposes a patient to oral candidal infections?
- Age (extremes)
- Endocrine disease (diabetes- II/ uncontrolled I)
- Immunodef (systemic steroids, HIV)
- Nutritional def (iron)
- Smoking
What is the clinical presentation of pseudomembranous candidosis?
- White patch (plaque) on erythematous mucosa
- Can be scraped off
- Usually asymptomatic but discomfort when eating, burning sensation and bad taste
What is the clinical presentation of erythematous candidosis?
- Red, shiny, atrophic mucosa
- Painful and exacerbated by hot/ spicy foods
- Sometimes bilateral angular cheilitis
What is the clinical presentation of hyperplastic candidosis?
- ALWAYS found on inner labial commisures bilaterally or dorsum of tongue
- Raised and white
- Primarily seen in smokers and diabetic pts
How would you investigate hyperplastic candidosis and why?
- BIOPSY!
- Potential for malignant change
What tests can be used in the diagnosis and aid of treatment for oral canididosis?
- DIRECT SMEAR = not specific but will tell if fungal or not
- SWAB & SENSITIVITY = culture; shows how many bugs growing and what they are vulnerable to
- ORAL RINSE = rinse w/ 10ml PBS –> cultured
- BIOPSY = chronic hyperplastic candidosis (looking for malignant change)
List some candida species
- C. albicans
- C. glabrata
- C. tropicalis
- C. krusei
- C. dubliniensis
