Candidosis Flashcards
How do candida and bacteria differ in size?
Candida approx. 25-100x bigger than bacteria
What is a mycofilm?
physical scaffold of fungi for bacteria to colonise
- creates a protective environment for bacteria
What are some risk factors for development of candidiasis?
- immunocompromised patients
- immunosuppressive drugs
- advanced HIV infection
- intra-abdominal surgery
- central venous catheter
- parenteral nutrition
- broad spectrum antibiotics
- dialysis
- diabetes
Candidal disease can be caused by a spectrum of infections, list some dentally relevant ones:
- periodontitis
- dental implants
- denture stomatitis
what type of oral candidosis is thrush?
pseudomembranous
what type of oral candidosis is denture related?
erythematous
what type of oral candidosis is HIV related?
erythematous
what type of oral candidosis is candidal leukoplakia?
hyperplastic
What can be used to treat angular chelitis?
topical miconazole
What are the different Newtons classifications of denture induced stomatitis?
Newtons type I = localised inflammation
Newtons type II = diffuse inflammation
Newtons type III = granular inflammation
what are the signs and symptoms of denture induced stomatitis?
- inflamed mucosa
- burning sensation
- discomfort
- bad taste
what type of candida species is NOT sensitive to miconazole and metroconazole?
candida glabrata!
what are hydrolytic enzymes?
the candida biofilm produces enzymes that catalyse the hydrolysis of a substrate through the addition of water
what are examples of hydrolytic enzymes?
- phospholipase
- haemolysin
- proteinase
What can candida in the mouth drive…
head and neck cancer
What are the different methods for diagnosis of oral candidosis?
- smear
- oral rinse*** (most common)
- swab*** (most common)
- foam pad
- biopsy
How do ‘Azoles’ antifungals work?
They work indirectly on the ergosterol diasynthesis pathway, preventing ergosterol being synthesised
- fungistatic
How do ‘polyenes’ antifungals work? eg. Nystatin
they work directly on the ergosterol by binding to it and cause pores, which leads to leakage of cytoplasmic contents leading to cell death
- fungicidal
If an immunocompromised patient presents with a candida infection, what should you do?
- systemic antifungal (eg fluconazole)
+ - topical antifungal (nystatin/miconazole) AND chlorhexidine rinse
If a patient presents with candida that is not immunocompromised and has poor OH, what is the treatment?
- improve OH
- chlorhexidine rinse
If a patient presents with candida that is not immunocompromised and good OH, what is the treatment?
Any topical or systemic antifungal
If a patient presents with candida that is not immunocompromised and a dry mouth, what is the treatment?
- topical antifungal
AVOID systemic antifungal
