Test 3: Oral Candidiasis and Other Candida Infections Flashcards
What is the most common cause of all fungal infections in oral cavity?
Candida
T/F: Candida is regular, normal human microbiota
True!
- it is in skin, GI, vagina, oral cavity
Where does Candida become invasive?
- typically in immune compromised host
T/F: Candida infections are only superficial mucosal inflammatory reactions.
False!
they vary from superficial mucosal inflammatory reactions to severe systemic disease
What is the morphology of Candida albicans?
- white colonies (“alba”)
- dimorphic so alternates between yeast and hyphal mold by responding to temperature and concentration of nutrients
- yeast has the round/ovoid with elongated pseudohyphae
- mold/hyphal has formation of pseudohyphae and true hyphae
What is a unique factor in Candida albicans morphology?
- formation of germ tubes which is a long hyphal outgrowth
- formed during initial stage of hyphal formation
What particular test can you do on Candida albicans to differentiate it?
Germ Tube Test
What are the 3 main virulence factors of Candida albicans?
- adhesion proteins (for adhesion to stick to mouth and teeth)
- acid proteases (for degradation of healthy tissue)
- phospholipase (for invasion and for hyphal formation)
Where do you see phospholipase?
- concentrated at hyphal tip
How is Candida albicans transmitted?
- overgrowth of person’s own normal flora
(seen mainly in immunocompromised patients) - can also be acquired from exogenous sources like catheters and person-to-person by newborns passing through infected birth canal
Which fungal infection has a high resistance to antifungals?
- candida auris
What are the predisposing factors to immunosuppression and more susceptible to Candida albicans?
- very young and elderly because have lower immunity
- persons living with HIV, transplant recipients
- malignancy, cytotoxic therapies
What predisposing factors the lead to oral disease and more susceptible to candida albicans?
- prosthetic/dentures
- diabetes/high sugar intake
- sjogrens syndrome- xerostomia
T/F: antibiotic therapy is a predisposition of Candida albicans
True!
- it eliminates normal flora allowing for overgrowth of Candida albicans
What are the diseases caused by Candida albicans?
- oral candidiasis
- skin and nail infections
- urogenital infections
What are the 5 types of oral candidiasis caused by Candida albicans?
- pseudomembranous candidiasis (thrush)
- erythematous candidiasis (denture-related)
- angular cheilitis
- chronic hyperplastic leukoplakia
- median rhomboid glossitis
How do we differentiate pseudomembranous candidiasis (thrush) from other candidiasis?
- cream-colored, crumbling, curd-like white patches
- rub off easily
- common in new borns, abnormally low neutrophils, broad-spectrum antibiotics, inhaled steroids
How do we differentiate erythematous candidiasis from other candidiasis?
- red, inflamed areas
- NO white curd like patches
- can be related to dentures, living with HIV, prolonged drug therapy, and sjorgens syndrome
How do we differentiate angular cheilitis from other candidiasis?
- painful, cracked sores at corners of mouth
How do we differentiate chronic hyperplastic leukoplakia from other candidiasis?
- individual white lesion
- white patches can NOT be rubbed off
How do we differentiate median rhomboid glossitis from other candidiasis?
- localized, central papillary atrophy of tongue
- smooth, lobulated dark pink to red area on dorsum of tongue
- common in smokers of tobacco and inhalation steroid users
What do we need to know about chronic mucocutaneous candidiasis?
- persistent and/or recurrent with skin, nails, and oral cavity
- can manifest in different ways
- more defects in immune system
What do we need to know about urogenital candidiasis?
- vulvovaginitis (yeast infection)
- candida balanitis
these can have some oral complications with these… prevention via safe sex practices
What are the 3 diagnosis of Candida albicans?
Direct Microscopic Examination by:
- wet mount using 10% potassium hydroxide (KOH)
- stain to visualize morphology
- observe for round/ovoid yeast cells, pseudohyphae, and hyphae
Culture by:
- Sab’s agar
- ideal method but slow
Germ Tube Test
What are important things to address in Candida albicans?
- oral hygiene measures
- dietary advice (reduce carbs)
- denture trauma (fit correctly)
- steroid inhaler use (brush/rinse after inhalation)
- other systemic factors
T/F: There is a vaccine for Candida albicans
FALSE!
