MYCOTIC INFECTIONS
CANDIDIASIS
(CANDIDOSIS,
•
MONILIASIS, THRUSH)
Because of the genus name
← Monilia, the disease is
called as moniliasis
Image credit: google
It is the most common fungal or mycotic infection
affecting human being. It occurs mainly as a
secondary infection in immunocompromised
patients. It affects skin, mucous membrane, nails and
internal organs.
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CAUSATIVE ORGANISMS:
G -
Other organisms:
Predominant
causative organism: • C. parapsilosis,
• C. stellatoidea,
• Candida Albicans • C. krusie,
• C. rugosa
PREDISPOSING FACTORS:
• Person who is taking medications, e.g., antibiotics
and immunosuppressive drugs.
• Radiation therapy.
• Chronic illness.
• Systemic diseases, e.g., diabetes, anaemia,
myxoedema and Addison’s disease.
• Immunocompromised patients, e.g., AIDS.
• Severe debilitation.
• Nutritional deficiency, e.g., vitamins A and B6,
iron.
• Old age or infants.
• Pregnancy.
• Denture wearer and smokers.
CLINICAL FEATURES:
• Candidiasis occurs mostly as the superficial
infection of the mucous membrane or skin, but
deeper structures like oesophagus, lungs or
endocardium, are involved in severely
debilitated or immunosuppressed persons.
Oral candidiasis
Oral Pathology: Clinical Pathologic Correlations,
Regezi, Sciubba, Jordan.
ORAL MANIFESTATION:
• Classified into the following types:
Name of the Clinical Common Associated
Clinical TypeAppearanc Sites of Factors
e and occurre
Symptoms nce
Pseudomembra Creamy- Buccal Antibiotic
white mucosa, therapy,
plaques, tongue, immunosuppre
removable palate ssion
nous (thrush) ; burning
sensation,
foul taste
Erythematous Red Posterio Antibiotic
macules, r hard therapy,
burning palate, xerostomia,
sensation buccal immunosuppre
mucosa, ssion,
dorsal idiopathic
tongue
Central Red, Midline Idiopathic,
papillary atrophic posterio immunosuppre
atrophy mucosal r dorsal ssion
(median areas; tongue
rhomboid asymptom
glossitis) atic
Red areas, Posterio Immunosuppres
often with r palate, sion,
removable posterio idiopathic
white r dorsal
Chronic plaques; tongue,
multifocal burning angles of
sensation, mouth
asymptom
atic
Red, Angles of Idiopathic,
fissured mouth immunosuppre
lesions; ssion, loss of
irritated, vertical
raw dimension
Angular feeling
cheilitis
Denture Red, Confined Probably not
stomatitis asymptom to true infection;
(chronic atic palatal denture often
atrophic denture is positive on
candidiasis, bearing culture but
denture sore mucosa mucosa is not
mouth)
Hyperplastic White Anterio Idiopathic,
(candidal plaques r buccal immunosuppre
leukoplakia) that are mucosa ssion; care
not must be taken
removable not to confuse
; this with
asymptom other
atic keratotic
lesions with
superimposed
candidiasis
Mucocutaneo White Tongue, Rare;
us plaques, buccal inherited or
some of mucosa, sporadic
which palate idiopathic
may be immune
removable dysfunction
; red areas
Endocrine- White Tongue, Rare;
candidiasis plaques, buccal endocrine
syndromes most of mucosa, disorder
which are palate develops after
not candidiasis
removable
Image credit:
Oral Pathology: Clinical Pathologic Correlations,
Regezi, Sciubba, Jordan.
Textbook of oral pathology, Shafer.
HISTOLOGICAL FEATURES:
n
• It is diagnosed based on presence of hyphae or
pseudohyphae, these are varying in their
length and may show branching.
• The common features are increased thickness of
parakeratin on the surface of the lesion along
with elongation of epithelial rete ridges.
• The candidal hyphae are embedded in
parakeratin
• Neutrophilic infiltration (microabcess), Chronic
inflammatory cell infiltrate can also be seen.
Fungal pseudohyphae
Oral Pathology: Clinical Pathologic Correlations,
Regezi, Sciubba, Jordan.
Image credit: google
TREATMENT:
• Removal of primary etiological factors and
maintenance of proper oral hygiene
• In conventional cases, topical and systemic
administration of nystatin is done.
• In immunosuppressed patient, systemic
administration of amphotericin-
B and fluconazole may be necessary
