Surgical management of chronic hyperplastic candidiasis refractory to systemic antifungal treatment (original) (raw)
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Oral Candidiasis: An Overview and Case Report
Era's Journal of Medical Research
INTRODUCTION Oral candidiasis is common and under diagnosed among the elderly, particularly in those who wear dentures and in many cases is avoidable with a good mouth care regimen. It can also be a mark of systemic disease, such as diabetes mellitus and is a common problem among the immunocompromised. Oral candidiasis is caused by an overgrowth or infection of the oral cavity by a yeast-like fungus, candida (1-2). The important ones are C albicans, C tropicalis, C albicans, C glabrata, C glabrata and C tropicalis represent more than 80% of isolates from clinical infection (3). Oral candidiasis is the most common human fungal infection (4-5). Incidence of C albicans isolated from the oral cavity has been reported to be 45% in neonates, (6) 45%-65% of healthy children, (7) 30%-45% of healthy adults, (8-9) 50%-65% of people who wear removable dentures, (9) 65%-88% in those residing in acute and long term care facilities, (9-12) 90% of patients with acute leukaemia undergoing chemotherapy, (13) and 95% of patients with HIV (14). CASE REPORT Patient age 34 years old reported to department of Oral and maxillofacial surgery with chief complaint of pain and burning sensation on left and right side of buccal mucosa (Fig 1 & 2) since 30-35 days. Medical history revealed patient was on steroid therapy. No releavant habit history was given by the patient. On Intra-oral examination it was seen that the lesion extended from canine to second molar region bilaterally. Lesion appeared to be reddish white in color. On palpation lesion revealed well defined margin with everted buccal mucosa. Brush biopsy of the lesion was performed and sent for examination which revealed Candidiasis. Anti fungal therapy was started and successful results were obtained after 2 months. Knowledge regarding intra-oral lesions is very essential for dental surgeon to arrive at appropriate diagnosis which indeed helps to provide proper treatment to patient.
Oral Potentially Malignant Disorders and Candida in Oral Tongue Squamous Cell Carcinoma Patients
Dentistry Journal
This retrospective study addressed the role of oral potentially malignant disorders and the presence of intraepithelial Candida hyphae in the carcinogenesis of the oral tongue squamous cell carcinoma and its association with smoking, alcohol consumption, and oral inflammatory burden. The medical records of 183 subjects diagnosed with oral tongue squamous cell carcinoma at the Helsinki University Hospital were investigated. Preceding oral lichen planus, lichenoid reaction, and leukoplakia diagnosis were recorded. Further, the data on Candida hyphae in histological samples as an indicator of oral candidiasis, oral inflammatory burden, smoking, and alcohol consumption were recorded and analyzed. The histopathological diagnosis of oral lichen planus/lichenoid reaction (p < 0.001) and the presence of Candida hyphae (p = 0.005) were associated significantly with female gender. Oral lichen planus/lichenoid reaction patients were less often smokers than patients without these lesions. Ca...
The journal of contemporary dental practice, 2016
Predisposing factors in chronic hyperplastic candidosis (CHC) have been poorly recognized. This study aimed at assessing the prevalence of Candida spp. in areas of the oral mucosa showing greater prevalent rate of CHC, such as the retrocomissural area, the lateral borders of the tongue, and the hard-palate mucosa in four groups of individuals presenting predisposing factors as follows: Smoking habits (group I); patients with low salivary flow rate (SFR) (hyposalivation - group II); patients with loss of vertical dimension of occlusion (LVDO -group III); and control subjects (group IV). A total of 44 individuals (age 4090 years, mean: 55.8 years) were divided into four groups: Group I (11 smokers); group II (10 hyposalivation patients); group III (10 LVDO patients); and group IV (control, 13 healthy subjects). All individuals were tested for Candida-pseudohyphae form by direct examination and for Candida spp. culture growth in samples obtained from the retrocomissural, tongue's l...
Presence of Candida albicans in potentially malignant oral mucosal lesions
Archive of Oncology, 2004
INTRODUCTION ecently, interest in the study of oral candidiasis has markedly increased mainly because of its association with human immunodeficiency virus (HIV) infection, but also due to its relation with potentially malignant lesions of oral mucosal. Many authors have studied the characteristics of oral mucosa in immunocompromised patients in order to find the differences in immunologic reactions to the development of candidiasis. There are a number of oral lesions that are clearly associated, more often than others, with either candidial infestation or frank invasion (1). The yeast-like fungus Candida albicans and a few other Candida species are capable of producing skin, mucous membrane, and internal infections. The organism lives with the normal flora of the mouth, vaginal tract, and gut, so the results of culture analysis must be interpreted carefully. Pregnancy, oral contraception, antibiotic therapy, diabetes, skin maceration, topical steroid therapy, certain endocrinopathies, and factors related to depression of cell-mediated immunity may allow the yeast to become pathogenic and produce budding spores and elongated cells (pseudohyphae) or true hyphae with septate walls. The yeast infects only the outer layers of the epithelium of mucous membrane and skin (the stratum corneum). The primary lesion is a pustule, the contents of which dissects horizontally under the stratum corneum
Gerodontology, 2010
Oral candidiasis mimicking an oral squamous cell carcinoma: report of a case Oral candidiasis is a significant problem in immune-compromised patients. The most common forms of mucosal candidiasis are oropharyngeal, oesophageal and vaginal, and more than 90% of HIV positive persons will manifest at least one episode of oropharyngeal candidiasis. Local and systemic factors such as uninterrupted daily use of a prosthesis by patients, smoking habit, as well as high glucose intake may contribute to the development of the lesion. The aim of this article is to report an uncommon case of oral candidiasis presenting an aggressive clinical behaviour in a 64-year-old male patient, with a significant smoking habit and a medical history of non-controlled diabetes. The lesion affected the hard and soft palate of the right side, revealing erythematous and ulcerated areas, elevated borders and central portions resembling necrosis, mimicking the clinical features of oral squamous cell carcinoma. However, the correct diagnosis of oral candidiasis was obtained after histopathological and cytological examinations and the patient was easily treated with traditional antifungal drugs and correction of his glucose levels.
Candida in malignant transformation of oral leukoplakia: A review
Journal of Oral Disease Marker
Among the fungi, Candida albicans is the most common microorganism to pose a possible risk factor for the malignant transformation (MT) in oral potentially malignant disorders (OPMDs). The presence of candidal infection may increase the risk of a OPMDs malignant potential. Histologically diagnosed fungal infection of the oral mucosa has been shown to exhibit epithelial dysplasia and vice versa. The rate of MT in leukoplakia with candidal infection is higher than that in uninfected leukoplakia. If left untreated, candida leukoplakia has a higher rate of neoplastic changes as compared to non-candida leukoplakia. Strong evidence of the fungal involvement in MT of oral leukoplakia is displayed by this higher rate of conversion. The current article reviews the potential role of candida infection in the MT of oral leukoplakia.
Clinical, therapeutic, and pathogenic aspects of chronic oral multifocal candidiasis
Oral surgery, oral medicine, and oral pathology, 1983
In 32 patients (11 females, 21 males) the diagnosis of chronic oral multifocal candidiasis was established on the basis of erythematous, plaquelike, or nodular lesions in two or more of the following locations: commissural area, palate, or dorsum of the tongue. Hyphae and/or pseudohyphae of Candida-like organisms were demonstrated in PAS-stained smears from all lesions. Ninety-seven separate lesions were registered. Thirty patients experienced pain, burning, or itching from affected areas. All of the patients were tobacco smokers, and 21 were denture wearers. The patients were treated with antimycotics; the median length of treatment was 46 days for denture wearers and 44 days for nondenture wearers. After antimycotic therapy the change in the lesions followed certain patterns which were determined by the original type of lesion. Palatal lesions in nondenture wearers and nodular lesions of the commissural areas showed the highest recurrence rate after 6 and 12 months. The pathogenic...
Candida: case report of an uncommon presentation of the common culprit
Journal of the Irish Dental Association
Candida albicans is present as a normal commensal fungus of the oral cavity in 35-69% of the healthy adult population. Infection is caused by an overgrowth of these normal fungi, which can be precipitated by systemic or local host factors. Thrush is a well-known and recognisable presentation of oral candidiasis; however, it is prudent that clinicians be aware of other less common presentations. Here we describe a case involving soft tissue changes in the oral cavity that proved to be a diagnostic challenge for clinicians across various disciplines. This case aims to highlight the diagnostic dilemma that can face clinicians when diagnosing oral lesions and the benefits of a multidisciplinary approach. Candidiasis may not always present as a white coating on the mucosa, but can also cause soft tissue changes of the tongue. The patient’s medical history should be thoroughly inspected to identify any potential contributing factors.
Translational Research in Oral Oncology, 2019
The aim of this systematic review was to investigate the malignant transformation of oral leukoplakia (OL) infected with Candida. Literature search was conducted using Medical Subject Heading terms ‘leukoplakia’, ‘neoplasms’, ‘ Candida’, ‘malignant transformation’ and ‘oral’ and included all results until February 2017. The initial search identified 372 articles, which was consolidated to 16 articles after applying inclusion and exclusion criteria. The occurrence of candidal infection in OL ranged from 6.8% to 100.0%. Only 3 of 16 studies reported malignant transformation rates of leukoplakia with Candida infection. The overall malignant transformation rates reported in these studies were 2.5%, 6.5% and 28.7%. This review supports the contention that candidal infection promotes cellular and dysplastic changes in OL. However, further follow-up studies are recommended to confirm the role of Candida infection in malignant transformation of OL lesions.
Differential diagnosis and therapeutic characteristics of oral candidiasis
Acta stomatologica Naissi, 2013
Oralna kandidijaza je česta oportunistička infekcija u usnoj duplji izazvana prekomernim razmnožavanjem Candide specijes (najčešće Candida albicans). Kod 20-50% zdravih osoba Candida albicans je deo normalne flore usne duplje. Incidencija ovog oboljenja varira u zavisnosti od starosti pacijenta i predisponirajućih faktora (poremećaj funkcije pljuvačnih žlezdi-oralna suvoća, loša oralna higijena, nošenje zubnih proteza, dugotrajna upotreba lekova, ishrana zasnovana pretežno na ugljenim hidratima, pušenje, diabetes mellitus, Kušingov sindrom, maligna oboljenja, imunosupresivna stanja). Kod 2/3 bolesnika sa AIDSom oralna kandidijaza predstavlja rani znak oboljenja. Klinički se oralna kandidijaza manifestuje u obliku akutne (pseudomembranozna i atrofična kandidijaza) i hronične (atrofična, nodularna i mukokutealna kandidijaza) forme. Diferencijalno-dijagnostički kandidijaza se ubraja u bele lezije, pa je treba razlikovati od retikularne forme lihen planusa, leukoplakije, hemijskih oštećenja, mehaničkih oštećenja (kao što je grickanje oralne sluzokože), belog sunđerastog nevusa, drugog stadijuma luesa, difterije i dr. Nakon uzimanja istorije bolesti, identifikuju se i koriguju provocirajući faktori. Posle kliničkog pregleda i laboratorijske identifikacije izazivača oboljenja, primenjuju se adekvatni antifungalni lekovi: lokalno (rastvor Nistatina, Daktanol gel) ili sistemski (Flukonazol, Ketokonazol, Itrakonazol, Amfotericin B i dr.), dobra oralna higijena i sanacija zuba. Kod određenih rizičnih grupa pacijenata primenjuje se profilaksa antifungalnim lekovima koji smanjuju incidenciju i težinu oboljenja. U najvećem broju obolelih prognoza oboljenja je dobra.