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Fadel Muhammad Garishah




       Diponegoro Medical School
To be a medical research institution 2012
World Health Organization HIV/AIDS Staging
   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.
pharynx, and hypopharynx




hard and
soft palates


tongue
                              buccal mucosa
   Fungi kingdom; Opportunistic fungi
   Candida albicans is the species most
    commonly identified, but Candida
    tropicalis, Candida glabrata, and Candida
    krusei infections also occur.
   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.
Candida albicans induces a T helper 1 (TH1) and TH17 cell-mediated immune response
that is essential to clear the fungi.
   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
   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.
   Candida infection of the lateral lip (angular
    cheilitis) is another common complication.
   Physical examination,
   Potassium hydroxide (KOH) preparation
    (scraped material from a plaque),
   The response to antifungal therapy establish
    the diagnosis.
 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.

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1.1 oral candidiasis

  • 1. Fadel Muhammad Garishah Diponegoro Medical School To be a medical research institution 2012
  • 2. World Health Organization HIV/AIDS Staging
  • 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.
  • 4. pharynx, and hypopharynx hard and soft palates tongue buccal mucosa
  • 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.