3. Candida Flashcards
What purpose does candida serve in the oral biome ?
Provides physical scaffold for bacteria - ‘mycofilms’.
Creates protected growth.
What are the key risk factors for candida infection ?
Immunocompromised.
Advanced HIV.
Parenteral nutrition.
Broad spectrum antibiotics.
Long term corticosteroid use.
Diabetes
What are the two significant candida in the mouth ?
Candida albicans.
Candida glabrata.
What treatment should be used to treat Candida albicans infection ?
Fluconazole and miconazole.
What treatment should be used to treat Candida glabrata infection ?
Nystatins.
What are the 5 types of candidal infection ?
Pseudomembranous.
Erythematous.
Hyperplastic.
Angular chelitis.
Chronic mucocutaneous - generalised candidasis with oral manifestations.
What is an example of pseudomembranous candida infection ?
Thrush.
What is an example of erythematous candida infection ?
Denture induced stomatitis.
What is an example of hyperplastic candida infection ?
Candida leukoplakia (pre-malignant).
What clinical findings would be related to pseudomembranous candida infection ?
White raised patches (lots of yeast hyphae above tissue surface).
Easily wiped away with scraping with some bleeding.
Common in untreated HIV patients.
What clinical findings would be related to erythematous candida infection ?
Inflamed mucosa.
Burning sensation.
Discomfort.
Bad taste.
What causes denture induced stomatitis ?
Fungal organisms failed to be removed from oral surface through OH.
Adhere and colonise on acrylic surfaces via co-aggregation and biofilm formation.
What is the biggest risk with pseudomembranous and erythematous candida infection ?
Risk of aspiration pneumonia.
What classification system can be used for erythematous candida infection ?
Newtons type 1 - localised inflammation.
Newtons type 2 - diffuse inflammation.
Newtons type 3 - granular, more widespread inflammation.
What causes chronic hyperplastic, oral candida leukoplakia ?
Yeast hyphae grow into tissues and cannot be scraped off.
Can be sign of pre-malignancy.
What is the correlation between candida and head and neck cancer ?
Alcohol product of years production - not cariogenic in itself.
Causes production of acetaldehyde enzymes - carcinogenic causing DNA damage.
What other bacteria is associated with angular chelitis ?
S. Aureus (gram-positive bacteria).
What treatment would be given for angular chelitis ?
Topical miconazole (gel).
What is the difference between Candida albicans and candida glabrata ?
Candida albicans - forms hyphae - can be seen under microscope.
Candida glabrata - does not form hyphae.
This can determine what type of infection when looking under microscope.
How do azole drugs work ?
Target ergosterol biosynthetic pathway - ergosterol component in fungal cell membrane and interruption alters membrane stability, permeability and action of membrane-bound enzymes.
How does polyenes (nystatin) drugs work ?
Creates pores in cell membrane causing leaking of cytoplasmic contents and results in cell death.
What anti-fungal drugs come in topical preparations ?
Nystatin and miconazole.
What anti-fungal can be administered systemically ?
Fluconazole - capsulated.
What micro-organisms can miconzaole be used to treat ?
All candida with varied sensitivity and staphylococcus.
Use to treat angular chelitis.