Biofilms III - Candidosis

Question 1

Give examples of risk factors for developing candidiasis

Answer 1

Immune-compromised patients
Immunosuppressive drugs
Advanced HIV infection
Diabetes
Long term corticosteroid use

Question 2

Give examples of different candidal diseases

Answer 2

Periodontitis
Denture stomatitis
Endocarditis
UTIs
CF lung infections

Question 3

How is candidosis confined to the mouth and commissure classed?

Answer 3

Pseudomembranous - thrush
Erythematous - strophic (HIV related) or denture related
Hyperplastic - candidal leukoplakia
Angular cheilitis

Question 4

What is generalised candidosis with oral manifestations called?

Answer 4

chronic mucocutaneous candidosis

Question 5

What are the different types of denture stomatitis?

Answer 5

Newton’s type I - Localised inflammation
Newton’s type II - Diffuse inflammation
Newtons type III - Granular inflammation

Question 6

What are the signs and symptoms of denture stomatitis?

Answer 6

Inflamed mucosa
Burning sensation
Discomfort
Bad taste

Question 7

Give examples of candida species

Answer 7

Candida albicans
Candida glabrata
Candida tropicalis

Question 8

Describe the prevalence of candida albicans?

Answer 8

Present in 71% of healthy individuals
Found most in oral cavity, vagina, gut (mucosal surfaces)

Question 9

What is the mortality rate of a candida bloodstream infection?

Answer 9

35%

Question 10

What effects do hydrolytic enzymes have on candida infections?

Answer 10

Phospholipase - host cell penetration
Haemolysin - facilitates hyphal invasion
Proteinase - adhesion to epithelial cells

Question 11

What is the link between candida and oral cancer?

Answer 11

The alcohol produced by candida are not carcinogens however they can be turned into acetaldehydes which are, and drive processes that cause DNA damage

Question 12

What lab tests are used to diagnose candida infections?

Answer 12

Germ tube formation
Sugar assimilation
Antifungal sensitivity
Typing

Question 13

What drugs can be used to treat candida infections?

Answer 13

Chlorhexidine
Azoles - Fluconazole, Miconazole
Polyenes - Nystatin
Echinocandins - Caspofungin

Question 14

Summarise the effects of different antifungal agents

Answer 14

Azoles are ineffective against biofilms
Polyenes and echinocandins are effective
Chlorhexidine is effective
Novel antifungal compounds such as tea tree oil can be used

Question 15

When can chlorhexidine rinse be prescribed?

Answer 15

If patient is immunocompetent and has poor oral hygiene

Question 16

When can any topical or systemic antifungal be prescribed?

Answer 16

If patient is immunocompetent, has good oral hygiene, doesn’t have dry mouth and has no large erosive lesions

Question 17

When should topical antifungals be prescribed but systemics avoided?

Answer 17

If patient is immunocompetent and has dry mouth

Question 18

When should systemic antifungals and topical antifungals/chlorhexidine rinse be prescribed?

Answer 18

If patient is immunocompromised or immunocompetent with large erosive lesions