Oral Candidiasis

Excerpt

Oral candidiasis is an infection of the oral cavity by Candida albicans, first described in 1838 by pediatrician Francois Veilleux. The condition is generally obtained secondary to immune suppression, which can be local or systemic, including extremes of age (newborns and elderly), immunocompromising diseases such as HIV/AIDS, and chronic systemic steroid and antibiotic use. An example of local immunosuppression is inhaled corticosteroids, often prescribed in the preventive treatment of asthma and chronic obstructive pulmonary disease.

Even though acute pseudomembranous candidiasis, also known as thrush, is the most common form of oral candidiasis, it is important to recognize that other types of oral candidiasis exist and that candidal infection can present as white and erythematous lesions. White lesions include acute pseudomembranous candidiasis and chronic hyperplastic candidiasis; red lesions include acute and chronic erythematous candidiasis, angular cheilitis, median rhomboid glossitis, and linear gingival erythema. Other rare oral types not included in these categories are cheilocandidiasis, chronic mucocutaneous candidiasis, and chronic multifocal candidiasis. However, such types are beyond the scope of this article.

Diagnosis of oral candidiasis is often clinical, based on clinical examination, medical history taking, and assessment of risk factors. A biopsy is recommended for certain types in addition to empirical treatment. Cultures are usually done if antifungal treatment is ineffective. Topical antifungal therapy and oral hygiene measures are generally sufficient to resolve mild oral candidiasis, and systemic antifungal therapy is usually reserved for patients who are refractory or intolerant to topical treatment and those at increased risk of developing systemic infections.