Diagnosis Of Oral Candidiasis Research Articles

Oral Candidiasis as a Marker of HIV Disease Progression Among Zimbabwean Women

To estimate oral disease prevalence among Zimbabwean women by HIV serostatus and CD4 cell count and to assess accuracy of oral disease diagnoses made by nurses as compared with an oral surgeon. Standardized oral mucosa examinations were performed by trained nurse-examiners and by an oral surgeon among women recruited in Harare, Zimbabwe. A total of 461 women (320 HIV-infected, 141 uninfected) were seen by nurses and an oral surgeon within a 2-week period. Oral candidiasis (OC) was the most common lesion diagnosed in nearly one quarter of HIV-infected women, whereas hairy leukoplakia and Kaposi sarcoma were found in <3%. The prevalence of OC diagnosed by nurses or the surgeon was significantly higher among women with a CD4 count <200 cells/mm than in women with a CD4 count from 200 to 499 cells/mm3 or a CD4 count >499 cells/mm3. The sensitivity of nurse examinations compared with examinations by the oral surgeon among HIV-infected women for the diagnosis of OC was 73%, the specificity was 95%, and the kappa-statistic was 0.71. OC was the most common lesion in HIV-infected women and was strongly associated with a low CD4 cell count. Interexaminer agreement was good for the diagnosis of OC among HIV-infected women. This study suggests that OC may play a role, in combination with other clinical indicators as a marker of disease progression in resource-poor settings.

A Case of Sycosis Candidiasis on the Upper Lip

A 72 year-old man was referred to our department with white curd-like material on the surface of his tongue as well as the mucosal surface of the lower lip, after unsuccessful treatment with itraconazole for 3 weeks. He also had a history of depression and had received topical steroid and/or antibiotics treatment for persistent oral aphtha and irritation of his upper lip for 4 years. A diagnosis of oral candidiasis was made through positive KOH direct microscopic examination and he was instructed to rinse his oral mucosal lesion with amphotericin B syrup. Although no significant eruption was observed on his upper lip at his first visit, he applied the steroid ointment for 4 weeks and came back to our clinic with his upper lip red and swollen. It was also covered with yellow crusty material mixed with a pustule. Histological examination of the lips revealed non-specific chronic inflammation in the mid to lower dermis. Hyphae in the cornea detected by PAS and Grocott staining. KOH direct microscopic examination from the pustule and crust showed positive pseudohyphae although no sign of parasitism to the hair was seen. Candida albicans and Candida parapsilosis were detected by culture from the crust and a biopsy sample. He was successfully treated with 2 courses of pulse therapy of oral itraconazole for sycosis candidiasis, accompanied by 2% miconazole gel for oral candidiasis.

Quantitative relationships between Candida albicans in saliva and the clinical status of human subjects

Patients with candidiasis had greater than 400 colony-forming units per ml of saliva, whereas carriers of Candida albicans had less than 400 colony-forming units per ml. Thus, quantitative cultures of saliva may aid in the diagnosis of oral candidiasis.