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What species cause candida infections?
- Commensal organisms, that are opportunistic pathogens.
- Most common C.albicans
- Others C.Glabrata, Tropicalis, Krusei.
- Theses more common in immunosuppressed and neutropenic pts.
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Local predisposing factors?
- Denture wearer
- Poor denture hygiene/OH
- Smoker
- Mucosal trauma
- Local drugs e.g. steroid inhaler
- Xerostomia (drugs, SS, radio, diabetes)
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Systemic predisposing factors?
- Age -extremes (newborn/elderly)
- Drugs - AB, steroids
- Immunodef/compromised
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Types of candida infections, classified as ACUTE and CHRONIC name them:
- Acute -
- A. Pseudomembranous candidosis
- A. Atrophic candidosis
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Chronic -
- C. atrophic
- C. Mucocutaneous
- C. hyperplastic
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What does Acute Pseudomembranous candidosis look like?
- Soft, friable, creamy white plaque on mucosa
- Can be wiped off, leaves an erythematous base
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What investigation would you do, what would you find? Acute Pseudomembranous candidosis:
Swab, stained smear will show yeasts, hyphae, leukocytes, debris
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Cause of Acute Atrophic Candidosis?
- Long term steroid/AB
- Pts with HIV
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What does Acute Atrophic Candidosis look like?
- Patchy red mucosal macules due to candida.
- Painful
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Chronic atrophic candidosis fts?
- Denture wearers (upper), ortho appliance - continual wear, ill fit, porosity of MMA harbours species
- Smokers
- Asymptomatic
- Erythema of mucosa
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Dx of Chronic atrophic candidosis
- Clinical Dx
- May need to exclude Diabetes.
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Chronic Mucocutaneous candidosis (CMC)?
- Group of rare syndromes in which there is persistent mucocutaneous candidosis that responds poorly to topical Tx.
- Skin, nails, mucosa
- Can be sporadic or have familial assoc.
- One type is assoc with autoimmune endocrinopathies
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Chronic hyperplastic candidiasis characterised by:
- Persistent white lesion, tough adherent plaque
- Cannot be scraped off
- Can have homogenous and non-homogenous areas, speckled
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Chronic hyperplastic candidiasis histopathology?
- Parakeratosis
- Chronic intra epi inflammation
- Fungal hyphae invading superficial layers of the epi
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Malignant change of Chronic hyperplastic candidiasis?
- 30% get dysplasia.
- May become carcinomas
- Depends on risk factors, appearance (speckled), degree dysplasia
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Chronic hyperplastic candidiasis management?
- Risk factors
- Antifungals
- Excision.
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What other lesions may involve candida species?
- Median Rhomboid Glossitis
- Angular Chelitis
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