Oral Candidiasis

Pathogenesis of Oral Candidiasis

• Transition from commensalism to pathogenicity often triggered by predisposing factors.
• Systemic Factors include:
  • AIDS
  • Malignancies
  • Diabetes mellitus (DM)
  • Immunosuppressive medications (e.g., broad-spectrum antibiotics)
• Local Factors include:
  • Poor oral hygiene
  • Use of acrylic dentures
  • Decreased salivary flow (xerostomia)

Classification of Oral Candidiasis

• Pseudomembranous Candidiasis (Thrush)

  • Most common form
  • Characterized by soft, friable, creamy white plaques on mucosa
  • Plaques can be wiped off, revealing a red, painful surface
  • Symptoms may include burning sensation and dysgeusia
  • Affects buccal mucosa, palate, tongue, oropharynx

• Erythematous (Atrophic) Candidiasis

  • Appears as flat, painful, red patches lacking a pseudomembranous coating
  • Commonly associated with burning sensation
  • Key clinical presentations include:
    • Median rhomboid glossitis (depapillation of the tongue)
    • Kissing lesions in palates
    • Angular cheilitis
    • Denture stomatitis (erythema on denture-bearing surface)

• Chronic Hyperplastic Candidiasis (Candidal Leukoplakia)

  • Presents with white papules or plaques that cannot be scraped off
  • Least common form
  • Affects corners of the mouth and dorsal surface of the tongue

Diagnosis of Oral Candidiasis

• Based on clinical signs and symptoms (burning sensation, dysgeusia, dysphagia)
• Culture or biopsy may be necessary in some cases

Antifungal Drugs

• Classified based on spectrum and activity:
  • Broad-Spectrum: inhibits a variety of fungi, including yeasts and molds
  • Narrow-Spectrum: inhibits a limited range of fungi
• Mechanisms of action:
  • Fungistatic: inhibits growth of fungi
  • Fungicidal: kills fungi

Types of Antifungal Drugs

• Membrane Disruptors:
  • Polyenes: Amphotericin B (AMB), Nystatin
  • Azoles:
    • Topical: Clotrimazole, Miconazole
    • Systemic: Ketoconazole, Fluconazole
• Other antifungals include Griseofulvin and Flucytosine

Introduction to Fungi

• Fungi comprise yeasts, molds, and mushrooms, possessing a membrane-bound nucleus.
• Fungal cell structures are similar to human cells but contain ergosterol instead of cholesterol.

Oral Candidiasis Overview

• Caused by Candida albicans, the most common opportunistic fungal infection in humans.
• Normally exists as a non-pathogenic member of human flora in the skin, oral cavity, gastrointestinal tract, and vagina.

This quiz covers the factors that contribute to the development of oral candidiasis, including systemic and local factors, as well as the classification of this fungal infection.