Oral candidiasis, or oral thrush "can be" used as pathognomonic diagnosis of human immunodeficiency. Taken from Mandell, Douglas, and Bennett's Principles & Practice of Infectious Diseases. Copyrights belong to owner. Educational purposes only.
3. Primary HIV infection has been associated
with severe aphthous stomatitis and with
oropharyngeal and esophageal candidiasis.
Candida infections of the hard and soft
palates, buccal mucosa, tongue, pharynx, and
hypopharynx are observed frequently.
5. Fungi kingdom; Opportunistic fungi
Candida albicans is the species most
commonly identified, but Candida
tropicalis, Candida glabrata, and Candida
krusei infections also occur.
6. Systemic Candida infections due to defects in
phagocyte function and number
Mucosal Candida infections result from
impaired cellular immunity.
Particularly as CD4+ lymphocyte counts fall
below 200 to 300/omm3.
An opportunistic infection, it is predictive of
the disease progression and development of
other AIDS-related infections.
7. Candida albicans induces a T helper 1 (TH1) and TH17 cell-mediated immune response
that is essential to clear the fungi.
8. Generally cottage cheese plaques that can
be removed with a tongue blade are seen on
the soft palate, tonsils, and buccal mucosa
Atrophic candidiasis: erythematous plaques
distrib-uted in the same way as the
pseudomembranous form of the disease but
without the characteristic white exudate.
Underdiagnosed by clinicians
9. Candida can cause a nonscrapeable white
plaque similar to that in hairy leukoplakia
(hypertrophic candidiasis).
Leukoplakia: corrugated lesions and hairlike
projections, candidal lesions are smooth.
10. Candida infection of the lateral lip (angular
cheilitis) is another common complication.
11. Physical examination,
Potassium hydroxide (KOH) preparation
(scraped material from a plaque),
The response to antifungal therapy establish
the diagnosis.
12. Wide use of oral triazole antifungal agents -
emergence of disease caused by drug-resistant
fungi
Patients treated with HAART, rates of flu-
conazole resistance were relatively low, even
though many had received several previous
courses of fluconazole, suggesting that
advanced immunosuppression is the most
important risk factor for resistance
Some species, C. krusei and C. glabrata, are
frequently less sensitive to fluconazole.