Oral Mycosis Research Articles

In Vitro Assessment of Antifungal and Antibiofilm Efficacy of Commercial Mouthwashes against Candida albicans.

Candida albicans is the most critical fungus causing oral mycosis. Many mouthwashes contain antimicrobial substances, including antifungal agents. This study aimed to investigate the in vitro activity of 15 commercial mouthwashes against 12 strains of C. albicans. The minimal inhibitory concentrations (MICs), minimal fungicidal concentrations (MFCs), and anti-biofilm activity were studied. MICs were determined by the micro-dilution method using 96-well plates, and MFCs were determined by culturing MIC suspensions on Sabouraud dextrose agar. Anti-biofilm activity was evaluated using the crystal violet method. The mouthwashes containing octenidine dihydrochloride (OCT; mean MICs 0.09-0.1%), chlorhexidine digluconate (CHX; MIC 0.12%), and CHX with cetylpyridinium chloride (CPC; MIC 0.13%) exhibited the best activity against C. albicans. The active compound antifungal concentrations were 0.5-0.9 µg/mL for OCT products and 1.1-2.4 µg/mL for CHX rinses. For mouthwashes with CHX + CPC, concentrations were 1.56 µg/mL and 0.65 µg/mL, respectively. Products with polyaminopropyl biguanide (polyhexanide, PHMB; MIC 1.89%) or benzalkonium chloride (BAC; MIC 6.38%) also showed good anti-Candida action. In biofilm reduction studies, mouthwashes with OCT demonstrated the most substantial effect (47-51.1%). Products with CHX (32.1-41.7%), PHMB (38.6%), BAC (35.7%), Scutellaria extract (35.6%), and fluorides + essential oils (33.2%) exhibited moderate antibiofilm activity. The paper also provides an overview of the side effects of CHX, CPC, and OCT. Considering the in vitro activity against Candida albicans, it can be inferred that, clinically, mouthwashes containing OCT are likely to offer the highest effectiveness. Meanwhile, products containing CHX, PHMB, or BAC can be considered as promising alternatives.

Personalized or unified approach in the prevention and treatment of oral mucositis in patients with malignant neoplasms of the head and neck organs: the choice of the optimal solution

Introduction. The prevalence of oncological diseases of the oropharyngeal region continues to grow steadily, but there is an increase for a number of nosologies in the five-year survival rate of this category of patients, which naturally leads to the actualization of accompanying treatment programs and the desire to improve the quality of life of oncological patients. One of the areas of maintenance therapy in oncology is dental support, the choice of approaches and methods of which is not systematically organized.Aim. To determine the optimal method of dental support for patients with malignant neoplasms of the head and neck organs for the prevention and treatment of oral mucositis.Materials and methods. At the Russian Scientific Center of Roentgenoradiology, retrospective analysis of scientific clinical results of oral mycosis treatment in patients with malignant tumors of the head and neck receiving antitumor therapy was performed.Results. Two main approaches have been identified for the prevention and treatment of oral mucositis in patients with malignant neoplasms of the head and neck organs: personalized and unified approach. using personalized approach, maximal mean value of oral mycosis severity during the whole antitumor treatment period per the Radiation therapy Oncology group (RTOg) classification was 2.19 ± 0.13. The quality of life of patients is reduced by 26.1 %. using unified approach, maximal mean value of oral mycosis severity during the whole antitumor treatment period per the RTOg classification was 2.44 ± 0.05. The quality of life of patients is reduced by 51.5 %, but at the same time, absolutely all patients retain the ability to eat independently and take care of the oral cavity.Conclusion. Both personalized and unified approaches for the prevention and treatment of oral mucositis are possible for use in clinical practice.

Quality of Life in Patients with End-Stage Renal Disease Undergoing Hemodialysis.

End-stage renal disease and hemodialysis therapy cause a number of changes, not only somatic but also psychosocial, including the patient’s perception and assessment of their quality of life. The literature describes predispositions to pathologies in the oral mucosa, craniofacial bones, teeth, and surrounding tissues in hemodialysis patients. This study aimed to determine the quality of life of hemodialysis patients in comparison with healthy subjects. The study group consisted of 200 subjects: the HD group (hemodialysis patients, n = 100) and the K group (control group, n = 100). General health and oral status were assessed using the following indices: plaque index, gingival index, probing depth, and clinical adhesion level. The WHOQOL-BREF survey was performed to determine both groups’ overall quality of life. The results showed lower values of assessed quality-of-life parameters in hemodialysis patients compared to the control group, especially in the somatic sphere. General diseases such as oral mycosis, osteoporosis, rheumatoid arthritis, and coronary-artery disease negatively impact the perceived quality of life. There are numerous indications for comprehensive psychological care of hemodialysis patients due to their poor psychosocial status.

Superficial Mycosis at the Avicenne Military Hospital in Marrakesh: 5-Years Review

Superficial mycosis were diagnosed in 1231 cases, a prevalence of 62.07%. The average age of the patients was 45 years, the sex ratio M/F was 1.19. The majority of the patients were followed as outpatients (96.99%). Of all superficial mycosis, onychomycosis was the most frequent with a rate of 52.32%, followed by epidermomycosis (37.44%), scalp mycosis (8.37%), oral mycosis (1.71%) and genital mycosis (0.16%). Dermatophytes were the most isolated (85.05%), followed by yeasts (13.65%), molds (1.30%). The main dermatophytic species were represented by Trichophyton rubrum (80.99%), followed by Trichophyton mentagrophytes var. interdigitale (8.88%) and Microsporum canis (6.59%). The most common yeasts found were Candida albicans (67.86%), followed by Malassezia furfur (22.02%). Scopulariopsis brevicaulis was the most isolated mold (68.75%). At the end of this study we conclude that mycological examination is essential in the management of patients with superficial mycoses; which must also include the elimination of favourable factors in order to avoid recurrence.

Coexistence of Lack of Clinical Manifestation of Oral Mycosis and Systemic Diseases in Edentulous Patients Using Removable Prosthetic Restorations.

Objective: It is believed that oral infections can increase the risk of systematic diseases, such as atherosclerosis and coronary heart disease, stroke, chronic obstructive pulmonary disease, diabetes, cancer, rheumatoid arthritis, etc. It seems that oral invasive pathogens induce a systemic inflammatory response via mediators released by the cardiovascular system and liver, which increases the risk to the patient of these systematic infections, such as hypertension. On the basis of previous studies of the stomatognathic system, investigating the coexistence of systemic diseases and inflammation in the oral cavity, it can be expected that there is a connection between inflammation of the denture-bearing area in patients using acrylic removable dentures and the presence of systemic diseases, and that patients with inflammation in oral mucosa are more likely to have systemic diseases. Material and method: A retrospective study was carried out on a group of patients seeking prosthetic treatment at the Prosthetic Department of the University Dental Clinic (UKS) from March 2012 to February 2013. All data were collected using a UKS electronic database with KS-SOMED. The minimum period of use for removable prostheses was five years. Results: According to anamnesis, the most common systemic diseases in our study group were hypertension disease. In total, 58% of patients with hypertension disease had no inflammation in the oral cavity. Conclusions: The occurrence of systemic diseases in edentulous people using removable prosthetic restorations, and the subsequent use of medications for these diseases, may result in a lack of clinical symptoms of concomitant fungal infection of the oral mucosa.

Geotrlchous stomatitis in the dental practice

A literature review was conducted on rare mycoses of the oral mucosa in patients with immunode^ciency conditions and hematologic malignant diseases, in particular, etiopathogenetic aspects, clinical features and an approach to the treatment of rare oral mycosis - geotrlchous stomatitis were examined.

Preparation and evaluation of an oral mucoadhesive gel containing nystatin-loaded alginate microparticles

Abstract Nystatin is an antifungal agent used for prophylaxis and treatment of candidiasis, especially oral mycosis. Efficacy of nystatin conventional dosage forms is limited by the short residence time and bitter taste of the drug. This research aims at designing an optimized formulation of oral mucoadhesive gel of nystatin-loaded alginate microparticles, which can be retained in the mouth. Sodium alginate solution containing nystatin was added to the solution of calcium chloride under stirring. Microparticles containing nystatin were incorporated into the Carbopol gel. Size, loading, and release profile and mucoadhesion were investigated. The most suitable microparticles with particle size of < 250 μm were prepared with alginate concentration of 1%(w/v), calcium chloride of 1%(w/v), drug:polymer concentration 1%, and ratio of alginate solution:calcium chloride of 1:10. This formulation showed 49.1% drug loading and 98.2% encapsulation efficiency. Carbopol 934 gel provided optimal mucoadhesive properties. Release profile proved a burst release, which can be attributed to the surface associated drug, followed by a slower sustained release phase for all microparticles. The developed system with ability to adhere to the oral mucosa has great appeal for treatment of localized infections and can mask bitter taste of the drug and be retained in the mouth for long periods.

Vultures from different trophic guilds show distinct oral pathogenic yeast signatures and co-occurrence networks

Vultures have evolved adaptive mechanisms to prevent infections associated with their scavenging lifestyle. However, food-borne exposure to antimicrobial pharmaceuticals can promote opportunistic infections with adverse outcomes. Here, we used multivariate and network analyses to increase understanding of the behavior of the yeast communities causing oral mycosis outbreaks recently reported in wild nestling cinereous (Aegypius monachus), griffon (Gyps fulvus) and Egyptian (Neophron percnopterus) vultures (CV, GV and EV, respectively) exposed to antibiotics from livestock farming. Common and unique yeast signatures (of Candida, Debaromyces, Diutina, Meyerozyma, Naganishia, Pichia, Rhodotorula, Trichosporon and Yarrowia species) associated with oral mycoses were identified in the three vulture species. Hierarchical clustering analysis (HCA) and principal component analysis (PCA) highlighted that oral lesions from CV and GV shared similar yeast signatures (of major causative pathogens of opportunistic mycoses, such as Candida albicans, Candida parapsilosis and Candida tropicalis), while EV had a distinct yeast signature (of uncommon pathogenic species, such as Candida dubliniensis, Candida zeylanoides, Pichia fermentans and Rhodotorula spp.). Synergistic interactions between yeast species from distinct fungal phyla were found in lesions from CV and GV, but not in EV. These formed co-occurrence subnetworks with partially or fully connected topology. This study reveals that the composition, assembly and co-occurrence patterns of the yeast communities causing oral mycoses differ between vulture species with distinct feeding habits and scavenging lifestyles. Yeast species widely pathogenic to humans and animals, and yeast co-occurrence relationships, are distinctive hallmarks of oral mycoses in CV and GV. These vulture species are more exposed to antibiotics from intensively medicated livestock carcasses provided in supplementary feeding stations and show higher incidence of thrush-like oral lesions than EV. These findings may be useful for development of new initiatives or changes in the conservation of these avian scavengers affected by anthropogenic activities.

PREVALENCIA DE MICOSIS ORAL POR Candida albicans, EN PACIENTES BAJO TRATAMIENTO EN EL HOSPITAL JOSÉ CARRASCO ARTEAGA (IESS)

OBJETIVO: Determinar la prevalencia de micosis oral por Candida albicans en pacientes entre 25 – 65 años de edad concáncer que se encuentran bajo radioterapia (RT) y/o quimioterapia (QT), en el hospital José Carrasco Arteaga en el año 2015.MATERIALES Y MÉTODOS: El presente estudio es de tipo descriptivo de corte transversal. La muestra cuenta con unacifra de 98 historias clínicas de pacientes atendidos en el Hospital José Carrasco Arteaga desde enero 2014 a junio 2015.RESULTADOS: Desde Enero 2014 a Junio 2015, 81 historias clínicas de pacientes que recibieron RT y/o QT, manifestandoCandida albicans, determinando una prevalencia de 82.7% de la muestra; el grupo de sexo masculino registró a 48 integrantesrepresentando el 59.25 %, el grupo femenino reportó 33 integrantes reportando el 40.75 %; los pacientes integrantes al grupo“mayores a 60 años de edad” registraron 46 personas, ocupando el 47% de la muestra. Un grupo de 66 personas recibieronRT manifestaron infección por Candida albicans. Pacientes sometidos a radiaciones comprendidas entre 51-70 Gy fueron28 individous, representando el 41.5% de la muestra estableciéndolo como el grupo con mayor relación. Un grupo 48personas recibieron QT manifestaron infeción por Candida albicans; donde destaca el uso del carboplatino en 15 personasrepresentando 31.3% de la muestra, estableciendo una relación directa del fármaco con la enfermedad fúngica. La ubicaciónfrecuente de Candida albicans en mucosa oral se registró en 57 casos, determinando una prevalencia de 44.9% de la muestra.CONCLUSIONES: La Candida albicans esta preste en el 82.7% de los pacientes bajo tratamiento contra el cáncer, afectandomayormente al sexo masculino. Presenta con más frecuencia en pacientes mayores a 60 años de edad, guarda mayor relacióncon tratamientos de radiación en dosis entre 51-70 Gy.

Primary Oral Cavity Mycosis Fungoides: Report of Two Cases

Primary Oral Cavity Mycosis Fungoides: Report of Two Cases

Management of oropharyngeal mycosis in head and neck cancer occurring during (chemo) radiotherapy: an Italian radio-oncologist survey.

Oropharyngeal candidiasis is a common disorder in head and neck cancer patients (HNCPs) who underwent (chemo)-radiotherapy. An Italian survey was conducted in order to investigate radiation oncologists' behavior in regard to diagnosis, prevention, and treatment of oral candidiasis. Between April and May 2013, a national online 18-question survey was sent to major Italian radiotherapy centers. All Italian regions were represented and 86 radiation oncologists were involved. Eighty-three percent of responders estimated that oropharyngeal candidiasis occurred in 30%-40% of their HNCPs. The majority of responders were able to recognize oral mycosis when it occurred in a localized pseudomembranous form and all responders agreed with the fact that oral candidiasis was always associated with mucositis. A prophylactic therapy was prescribed occasionally by 35% and routinely by 20% of responders. Forty percent prescribed an antifungal drug in the case of suspected mycotic infection and 20% waited for symptomatic clinical evidence before prescribing a therapy. In the presence of candidiasis, mainly topical fluconazole (59%) and itraconazole (36%) were prescribed. Concomitant chemo-radiotherapy was first identified as a risk factor for mycosis occurrence and development. Ninety-nine percent of responders believed that oral mycosis was associated with increased toxicity and 44% of them interrupted treatment due to candidiasis. A variety of approaches to oropharyngeal candidiasis emerges from this survey; further clinical trials are necessary to identify the best approach for oral mycosis prevention and treatment and to establish specific international guidelines for HNCPs.

Oral mycosis fungoides: report with immune profile

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma that uncommonly involves the oral mucosa. Oral MF is an indication of systemic progression and is often associated with an unfavorable outcome. Any oral mucosal site may be affected. This report describes a case of MF involving the hard palate of a 64-year-old woman with confirmed skin MF. The histology showed intra- and subepithelial atypical lymphocytes. Immunohistochemistry on the tissue sections showed that the CD4:CD8 ratio was high (5.8:1) and the CD8:CD3 ratio was low (0.16:1). FoxP3(+) (forkhead box P3-positive) regulatory Tcells were conspicuous within the infiltrate, but few interleukin-17 cells were observed. This report is the first to describe a detailed immune profile in oral MF.

CPC-094 Nutritional Status of Hospitalised Patients with Head and Neck Cancer

BackgroundMalnutrition is common in hospitalised patients with head and neck carcinoma.PurposeThe aim of this study was to analyse the causes of hospitalisation of patients with head and neck cancer and...

Mycological Analysis of the Oral Cavity of Patients Using Acrylic Removable Dentures

Background. The problems of fungal infections in edentulous have been discussed in literature. Findings show that oral mycosis has an influence on the mycosis of oesophageal mucosa. Based on this we started to follow from 2007 in patients who wear dentures mycological examination, to evaluate changes of yeasts numbers, the sensitivity to antibiotics and determine the impact of types of prosthesis, time of using, gender and age of patients. 1230 patients who were wearing dentures participated in the retrospective study. The material for mycological examination was sampled as a smear from the palate. After the mycological identification of Candida species and assessment of growth, the susceptibility testing with Fluconazole and Nystatin was made. The number of 23 Candida species was diagnosed microbiologically in five years. C. albicans and C. glabrata were increasing in number—from 33,7% to 46,9% and 6,7% to 14,0%, respectively. There was a significant statistical difference between yeasts growth and gender (P = 0, 017 < 0.05). The conclusion is that a large percentage of persons wearing removable denture has been affected by Candida species and that could lead to the mycosis of farther gastrointestinal tract sections. The mycological examination before treatment, especially in patients using acrylic denture, appears to be necessary.

Oral Candidiasis

The frequency of mucosal and cutaneous fungal infection is increasing worldwide, which is due to the increase of immunocompromised patients. Candida albicans are the principal species associated with human oral mycosis and are known to be the most virulent among pathogenic Candida spp. In this review, oral candidiasis were classified and oral mucosal manifestations of candidiasis were filed. And its diagnosis and management would be reviewed briefly.

Abatacept for severe anti–tumor necrosis factor α refractory juvenile idiopathic arthritis–related uveitis

To evaluate the safety and efficacy of abatacept in patients with severe juvenile idiopathic arthritis (JIA)-related uveitis refractory or intolerant to immunosuppressive and anti-tumor necrosis factor alpha (anti-TNFalpha) agents. Patients with JIA-related uveitis refractory to immunosuppressive and anti-TNFalpha agents were treated with intravenous abatacept (10 mg/kg monthly). Side effects, frequency of uveitis flares, and ocular complications before and after treatment were reported. Seven patients (6 females and 1 male) with a mean uveitis duration of 11.6 years entered the study. All patients had failed previous immunosuppressive therapy and >or=2 anti-TNFalpha treatments. All patients responded to abatacept and 6 maintained a clinical remission after a mean of 9.2 months of treatment. One patient withdrew from the study with oral mycosis and arthritis flare; no other patients had side effects. The mean frequency of uveitis flares during the 6 months before and after treatment decreased from 3.7 to 0.7 episodes. No new ocular complications or worsening of preexisting ones were reported. Abatacept treatment led to sustained improvement in severe anti-TNFalpha-resistant JIA-related uveitis and was well tolerated in all but 1 patient. These results provide new insights into a possible indication of abatacept for the treatment of uveitis.

Identification of Aspergillus Species in Oral Tissue Samples of Patients With Hematologic Malignancies by In Situ Hybridization: A Preliminary Report

A definitive diagnosis of invasive oral aspergillosis can be difficult because the culturing of tissue samples frequently fails to isolate Aspergillus species. In addition, the mycelial elements of Aspergillus species seen in tissue sections are histopathologically indistinguishable from those of non-Aspergillus species. We analyzed the usefulness of a DNA probe directed against the alkaline proteinase (ALP) gene of Aspergillus fumigatus for the identification of Aspergillus species by the in situ hybridization (ISH) technique in patients with oral mycosis. The ALP probe was tested on tissue specimens from 16 patients with hematologic malignancies who had invasive, orofacial fungal infections and a positive culture for one of the following organisms: Aspergillus species in 13 patients (A. flavus in 10, A. terreus in 2, and A. fumigatus in 1), and Exophiala dermatitis, Trichoderma longibrachiatum, and Candida albicans in 1 patient each. In situ hybridization with the ALP probe was performed using formalin-fixed, paraffin-embedded tissue samples. The ALP probe showed a strong reaction with specimens from all 13 patients who had culture-proven aspergillosis specimens attributable to A. flavus, A. terreus, and A. fumigatus. On the other hand, the ALP probe showed no cross-reactivity with other fungi (Exophiala dermatitis, Trichoderma longibrachiatum, and Candida albicans). These findings indicate that ISH using an ALP probe may increase the accuracy of diagnosing invasive oral aspergillosis in immunocompromised patients, and facilitate the provision of adequate antifungal treatment.

Toxicity induced by radiochemotherapy with weekly paclitaxel versus weekly cisplatin in patients with advanced head and neck cancer

16534 Background: Head and neck cancers represent about 8 % of the total solid cancer cases. For advanced head and neck cancer (HNC) patients, the effects of disease and the side effects of aggressive treatments have the potential to severely affect quality of life. Combined chemoradiotherapy increase rates of locoregional control, but it may cause severe side effects, mainly painful mucositis. In our study we evaluated the chemoradiotherapy induced toxicities in patients treated with concomitant radiochemotherapy using weekly paclitaxel or cisplatin for advanced head and neck cancer. Methods: From April 2003 to December 2005 46 patients with locally advanced head and neck cancer were enrolled onto this study. Patients characteristics: 35 male and 11 female; mean age 62,5; performance status ECOG 0–1, carcinoma histological confirmed. All patients received external beam radiation using DT= 45 Gy, 1,8 Gy/fr, 5 fr/week in combination with chemotherapy: arm A (20 pts) - Paclitaxel 35 mg/mp days 1,8,15,22,29; arm B (26 pts)- Cisplatin 20 mg/mp days 1,8,15,22,29. Results: 40 patients have completed the planed treatment; 4 patients have interrupted treatment because of toxicity; there were 2 toxic death due to neutropenic sepsis and metabolic disorders in arm A. Toxicity grade 3–4 was hematological - neutropenia - 14, 6 % pts in arm A vs. 7, 8 % pts in arm B; gastrointestinal - nausea 6,7 % pts in arm A vs. 5,6% pts in arm B; neurological - neuropathy 5,4 % pts in arm A vs. 0 pts in arm B; dermatological - radic dermitis 4,3% in arm A vs. 4,1% in arm B; oral mucositis 33,6% in arm A vs 27,8% in arm B. All this patients received analgesics and anti-inflammatory drugs, systemic and/or topical. Other toxicities were not significantly related. Conclusions: This study confirmed that radiochemotherapy has shown to provide clinical benefit response and disease stabilization in patients with locally advanced head and neck cancer. Unfortunately, this concomitant therapy was significantly associated with hematological toxicities and oral mycosis. The most severe side effect was oral mycositis grade 3–4, especially in the paclitaxel arm. No significant financial relationships to disclose.

Mycosis Fungoides Of The Tongue

Although oral mycosis fungoides lesions have been rarely reported in the literature, incidental autopsy findings indicate a higher occurrence. We present two patients with mycosis fungoides of the tongue. Both patients had advanced tumor stage mycosis fungoides when they each developed a single tongue lesion. Tongue involvement has been associated with poor prognosis.

Novel use of lasers in cutaneous disorders

There have been substantial advances in the use of lasers for skin disorders. The pulsed dye laser is the treatment of choice for vascular lesions and is also efficacious in psoriasis, acne vulgaris, and as a light source for photodynamic therapy. The long-pulsed alexandrite and neodymium: yttrium-aluminum-garnet lasers are effective for epilation even in darker skin types and may be useful for bulky and hypertrophic vascular lesions. The xenon chloride excimer laser has been introduced recently to dermatology and is efficacious for psoriasis and vitiligo. Other disorders, including hand dermatitis, oral lichen planus, alopecia areata and mycosis fungoides also appear to be responsive to this laser. A variety of lasers are used for non ablative rejuvenation, although improvement in appearance of photodamaged skin is modest at best. However, fractional photothermolysis and radiofrequency devices are recently introduced devices that are gaining popularity by facilitating the treatment of photodamage without...