Candidiasis

Question 1

Define candidiasis.

Answer 1

Oral candidiasis involves an infection of oral tissues by yeasts of the genus Candida, mostly C albicans. It is the most common oral fungal infection and is commonly seen in infants and older adults, and also with states of local and systemic immunological suppression.

Question 2

Explain the aetiology/risk factors of candidiasis.

Answer 2

Hyposalivation/xerostomia
Poor oral hygiene, especially among denture wearers
Malabsorption and malnutrition
Advanced malignancy
Cancer chemotherapy and radiotherapy
HIV infection
Endocrine disturbance (e.g., diabetes mellitus, hypoparathyroidism, pregnancy, hypoadrenalism)
Immunosuppressive agents (e.g., systemic corticosteroid therapy)
Current or recent past use of broad-spectrum or multiple narrow-spectrum antibiotics

Question 3

Summarise the epidemiology of candidiasis.

Answer 3

Oral candidal colonisation has been reported to range from approximately 40% to 70% of healthy children and adults, with higher rates observed among children with carious teeth and older adults wearing dentures.

Question 4

Recognise the presenting symptoms of candidiasis. Recognise the signs of candidiasis on physical examination.

Answer 4

Creamy white or yellowish plaques, fairly adherent to oral mucosa
Cracks, ulcers, or crusted fissures radiating from angles of the mouth
Lesions on any part of the oral mucosa
Atrophic, fiery red, flat lesions on the palate
Patchy areas of loss of filiform papillae on the dorsum of the tongue
Spotty red areas on the buccal mucosa
Lesions confined to the outline of a dental prosthesis
Burning oral pain

Question 5

Identify appropriate investigations for candidiasis and interpret the results.

Answer 5

Superficial smear of lesion for microscopy