CANDIDIASIS – DNB ENT Theory / VIVA / OSCE
- 1. CANDIDIASIS
- 2. PRODROMAL SYMPTOM of a
- 3. DIFFERENTIAL DIAGNOSIS of thrush includes
- 4. PREDISPOSING FACTORS.
- 5. HISTOLOGIC FEATURES.
- 6. ACUTE ATROPHIC CANDIDIASIS
- 7. ANTIFUNGAL TREATMENT
- 8. CHRONIC HYPERPLASTIC CANDIDIASIS
- 9. CHRONIC MULTIFOCAL CANDIDIASIS
- 10. CHRONIC MUCOCUTANEOUS CANDIDIASIS
- 11. IMMUNOCOMPROMISED (HIV)-ASSOCIATED CANDIDIASIS
- 12. TREATMENT OF ORAL CANDIDIASIS:
CANDIDIASIS
“CANDIDIASIS” refers to a multiplicity of diseases caused by yeast like fungus, Candida, and is the most common oral fungal infection in humans.
According to
Onset and Duration – (Acute or Chronic);
Clinical Features, including Color- (Erythematous/Atrophic);
Location – (Median Rhomboid Glossitis, Denture
Stomatitis,
Multifocal Candidiasis, and Angular
Cheilitis);
Skin lesions as well as oral lesions – (Mucocutaneous); and
Association with immunocompromised host – (HIV associated).
Hyperplastic or hypertrophic appearance – (Papillary Hyperplasia of The Palate,
Candidal Leukoplakia, and
Hyperplastic Median Rhomboid Glossitis).
Candida is predominantly an opportunistic infectious agent that is poorly equipped to invade and destroy tissue. The role of Candida as opportunistic invader versus etiologic agent in patient with oral white lesions has not been clearly established.
- In vitro and animal studies have suggested that Candida organisms CATALYZE THE PRODUCTION OF NITROSAMINE, which is considered to be carcinogenic.
- Previous studies by various investigators have demonstrated a significant CORRELATION BETWEEN EPITHELIAL DYSPLASIA AND FUNGAL INVASION, but the mechanisms responsible remain unclear.
- However, the demonstration of the statistically significant ASSOCIATION OF CERTAIN STRAINS WITH DYSPLASTIC RED AND WHITE LESIONS (SPECKLED LEUKOPLAKIA), AND THE HYPERPLASTIC EFFECTS ON EPITHELIUM OF CANDIDA IN VITRO, indicate that Candida may be a carcinogen or promoting agent, rather than only an innocuous opportunistic infectious entity.
ACUTE PSEUDOMEMBRANOUS CANDIDIASIS (THRUSH)
Thrush is the prototype of the oral infections caused by Candida. It is a superficial infection of the outer layers of the epithelium, and it results in the formation of PATCHY WHITE PLAQUES OR FLECKS ON THE MUCOSAL SURFACE.
Removal of the plaques by gentle rubbing or scraping usually reveals an AREA OF ERYTHEMA OR EVEN SHALLOW ULCERATION.
Because of their prevalence, characteristic appearance, and ease of removal, the lesions of thrush are easily recognized, and a diagnosis of thrush is frequently made on the basis of the appearance of the lesion.
A smear demonstrating a yeast or myelin is helpful when the diagnosis is uncertain.
Thrush is seen in children and in adults of all ages whenever the number of Candida organisms in the oral cavity increases significantly.
When Candida is reduced or eliminated by the administration of antifungal agents, the lesions of thrush rapidly disappear. Transient episodes of thrush may occur as isolated phenomena, with lesions that disappear spontaneously with minimal or no treatment.
These episodes are usually unrelated to any recognized predisposing factor and are common in neonates and young children.
Alternatively, the lesions may promptly recur following treatment, suggesting the persistence of a predisposing factor, as is often seen in Adult patients with candidiasis.
The typical lesions in INFANTS are described AS SOFT WHITE ADHERENT PATCHES ON THE ORAL MUCOSA. The intraoral lesions are generally painless and can be removed with little difficulty.
In the ADULT, INFLAMMATION, ERYTHEMA, AND PAINFUL ERODED AREAS are more often associated with this disease and the typical pearly white plaque like lesions are relatively inconspicuous at times.
Any mucosal surface may be involved and erythematous or white areas often develop beneath PARTIAL OR COMPLETE DENTURES.
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