Oral Candidiasis
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This is a fungal infection of the oral mucosa caused by Candida infection, mainly Candida albicans.
Clinical presentation Features of candidiasis are divided according to the types as follows:
Pseudomembranous
- White creamy patches/plaque
- Cover any portion of mouth but more on tongue, palate, and buccal mucosa
- Sometimes may present as erythematous type whereby bright erythematous mucosal lesions with only scattered white patches/plaques
Hyperplastic
- White patches leukoplakia-like which are not easily rubbed-off
Angular cheilitis (angular stomatitis)
- Soreness, erythema and fissuring at the angles of the mouth
- Commonly associated with denture mastitis but may represent a nutritional deficiency or it may be related to orofacial granulomatosis or HIV infection
Pharmacological Treatment
A: nystatin suspension (PO) 100,000IU (1 ml) mixture held in the mouth for at least 3minutes before swallowing, 6hourly
OR
C: miconazole gel (PO) 25mg/ml 5–10mls in mouth: hold in the mouth for 60 seconds before swallowing. The treatment should be continued for 5days after cure/clearance. Where topical application has failed, or candida infection has been considered severe, use:
A: fluconazole (PO) 150mg 24hourly for 7days
OR
D: itraconazole (PO) 200mg 24hourly for 7days
Note: Candidiasis has several risk factors. It is recommended that for HIV/AIDS patients with candidiasis, refer to the Tanzania HIV/AIDS Guidelines.