SPOTTERS MEDICINE
ORAL CANDIDIASIS
🔹 Definition:
Oral
candidiasis (oral thrush) is a fungal infection of the oral mucosa
caused by Candida species, most commonly Candida albicans,
leading to white plaques and mucosal erythema.
🔹 Causative Organism:
- Candida albicans (most common)
- Others: Candida glabrata,
Candida tropicalis, Candida krusei
🔹 Predisposing Factors:
- Immunosuppression (HIV, cancer, transplant)
- Diabetes mellitus
- Prolonged antibiotic/steroid use
- Dentures (especially ill-fitting)
- Poor oral hygiene
- Infancy and old age
- Smoking and dry mouth
(xerostomia)
🔹 Types of Oral Candidiasis:
1.
Pseudomembranous (Thrush):
o White plaques that can be scraped
off, leaving red base
o Most common type
2.
Erythematous (Atrophic):
o Red, sore areas without plaques
o Common after antibiotic use
3.
Hyperplastic (Chronic):
o White plaques that cannot be
scraped off
o May be precancerous
4.
Angular cheilitis:
o Fissures and redness at mouth corners
5.
Median rhomboid glossitis:
o Smooth red area on mid-dorsum of
tongue
🔹 Clinical Features:
- White curd-like plaques on
tongue, palate, buccal mucosa
- Burning sensation or discomfort
while eating/spicy food
- Cracks at mouth angles (angular
cheilitis)
- Redness and soreness (especially
in atrophic type)
🔹 Diagnosis:
- Clinical appearance
- KOH mount: pseudohyphae and budding yeast
- Gram stain: shows Gram-positive budding
yeasts
- Fungal culture if needed
🔹 Treatment:
Topical
Antifungals:
- Nystatin oral suspension
- Clotrimazole troches
- Miconazole gel
Systemic
Antifungals: (for
severe/recurrent cases)
- Fluconazole, Itraconazole (oral)
Supportive:
- Maintain oral hygiene
- Discontinue predisposing
medications if possible
- Treat underlying systemic
condition (e.g., diabetes, HIV)
🔹 Prevention:
- Proper denture hygiene
- Control of systemic illness
(e.g., diabetes)
- Avoid overuse of broad-spectrum
antibiotics
- Regular oral rinsing in
immunocompromised
🔹 Prognosis:
- Good with appropriate treatment
- Recurrence common if
predisposing factors persist
- Chronic candidiasis may be
associated with precancerous potential
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