Oral candidiasis

Question 1

Describe the pathophysiology

Answer 1

Caused by compromised normal flora of the mouth that allows for overgrowth of Candida fungal organisms– an opportunistic infection
Selectively occurs in people with weakened host defense mechanisms– a “disease of the diseased”

Question 2

What is primary vs secondary oral candidiasis?

Answer 2

Primary: local infection in the oropharyngeal region
Secondary: manifestation of generalized candida infection

Question 3

How does acute pseudomembranous candidiasis present?

Answer 3

Thrush
Creamy, whitish-yellow plaques on the mucosal lining of the mouth. Can be wiped off to expose a raw, erythematous base that usually isn’t painful.

Question 4

How does erythematous candidiasis present?

Answer 4

Atrophic candidiasis
Erythematous lesions that can cause depapillation and dekeratinization
Lesions often accompanied by inflammation of the surrounding tissues

Question 5

How does hyperplastic candidiasis present?

Answer 5

Candidal leukoplakia

Chronic lesions that appear as small white plaques or larger opaque lesions on the tongue, palate or inner cheek

Question 6

How does denture stomatitis present?

Answer 6

Chronic, red, edematous lesions found in denture wearers. Usually symptomless, but can have mild soreness

Question 7

How does angular cheilitis present?

Answer 7

Sore, erythematous fissuring at the angles of the mouth due to a mixed bacterial-fungal infection. Commonly associated with denture stomatitis.

Question 8

What are nonpharmacologic methods for treating candidiasis?

Answer 8

If using oral corticosteroids, use a spacer device
Be cautious when using dentures
Keep mouth moist
Control diabetes
Advise keeping toys/bottle nipples sterilized

Question 9

What are pharmacologic therapies for candidiasis?

Answer 9

Antifungals– nystatin 100 000 units/mL

**prescription option