CANDIDIASIS

DR DEBAJYOTI BARDHAN
INTRODUCTION
• ORAL CANDIDIASIS IS MOST PREVELENT
OPPURTUNISTIC INFECTION AFFECTING THE
ORAL MUCOSAE .
• ETIOLOGY -
CANDIDA ALBICANS
CANDIDA TROPICALIS
CANDIDA GLABRATA
THESE COMPROMISE OVER 80 % OF SPECIES
ISOLATED FROM HUMAN CANDIDA INFECTIONS
• A NUMBER OF PREDISPOSING FACTORS HAVE
THE CAPACITY TO CONVERT CANDIDA FROM
NORMAL COMMENSAL FLORA TO A
PATHOGENIC ORGANISM .
• CANDIDA IS USUALLY A WEAK PATHOGEN AND
CANDIDIASIS IS SAID TO AFFECT THE VERY
YOUNG , THE VERY OLD AND THE VERY SICK .
PATHOGENESIS

TO INVADE THE MUCOSAL LINING , THE

MICROORGANISMS MUST ADHERE TO THE
MUCOSAL SURFACE .
THE STRAINS OF CANDIDA WITH BETTER
ADHESION POTENTIAL ARE MORE PATHOGENIC
THAN THE STRAINS WITH POORER ADHESION
POTENTIAL .
THE CANDIDA PENETRATION OF THE MUCOSAL
SURFACES IS FACILITATED BY THE PRODUCTION
OF LIPASES
• THERE IS ASSOCIATION BETWEEN ORAL CANDIDIASIS
AND THE INFLUENCE OF LOCAL AND GENERAL
PREDISPOSING FACTORS .
• THE VARIOUS LOCAL PREDISPOSING FACTORS ARE
• DENTURE WEARING
• SMOKING
• ATROPIC CONSTITUTION
• INHALATIONAL STEROIDS
• TOPICAL STEROIDS
• HYPERKERATOSIS
• IMBALANCE OF ORAL MICROFLORA
• QUALITY AND QUANTITY OF SALIVA
•
• GENERAL PREDISPOSING FACTORS FOR ORAL
CANDIDIASIS
• IMMUNOSUPRESSIVE DISEASES
• IMPAIRED HEALTH STATUS
• IMMUNOSUPRESSIVE DRUGS
• CHEMOTHERAPY
• ENDOCRINE DISORDERS
• HEMATINIC DEFICIENCIES
•
CLASSIFICATION - PRIMARY
• ACUTE -
PSEUDOMEMBRANOUS
ERYTHEMATOUS
CHRONIC
PSEUDOMEMBRANOUS
ERYTHEMATOUS
PLAQUE LIKE
NODULAR
CANDIDA ASSOCIATED LESION
DENTURE STOMATITIS
ANGULAR CHELITIS
MEDIAN RHOMBOID GLOSSITIS
• SECONDARY -
• FAMILIAL CHRONIC MUCOCUTANEOUS
CANDIDIASIS
• DIFFUSE CHRONIC MUCOCUTANEOUS CAN
• CANDIDIASIS ENDOCRINOPATHY SYNDROME
• FAMILIAL MUCOCUTANEOUS CANDIDIASIS
• SEVERE COMBINED IMMUNODEFICIENCY
• DI GEORGE SYNDROME
• CHRONIC GRANULOMATOUS DISEASE
• ACQUIRED IMMUNE DEFICIENCY SYNDROME
EPIDEMIOLOGY
• THE PREVELANCE OF CANDIDA AS A PART OF
NORMAL ORAL FLORA SHOWS LARGE
GEOGRAPHIC VARIATIONS , BUT AN AVERAGE
FIGURE OF 35% HAS BEEN CALCULATED FROM
SEVERAL STUDIES .
• WITH IMPROVED DETECTION TECHNIQUES , A
PREVELANCE AS HIGH AS 90 % HAS BEEN
PROPOSED
• SEASONAL VARIATION WITH AN INCREASE IN
THE SUMMER MONTHS HAS BEEN OBSERVED .
• IN DENTURE WEARERS THE PREVELANCE OF
DENTURE STOMATITIS VARIES IN THE VARIOUS
POPULATION STUDIES IT HAS BEEN REPORTED
TO BE APPROXIMATELY 50 % .
 CLINICAL FEATURES

1.PSEUDBRANOUS CANDIDIASIS:
 Recognized as classic candida infection
 Affect the person medicated with antibiotics and
immunosupressant medicine
 Infection present with loosely attach membrane
comprising fungal organism n cellular debries
 There are two i.e acute and chronic which are
indistinguisable in clinical presentation.
 The chronic form may emerge from HIV infection
 Patient treated with steroid inhaler may also have this
kind of dieases
2.ERYTHEMATOUS CANDIASIS:
 Previously refered as atrophic candidiasis
 This lesion has a diffuse border which help to distinguish
it from erytroplakia.
 Consider as successor of pseudomembranous
candidiasis.
 Present in hard palate and dorsum of the tongue
 Predisposing factor are smoking and treatment with
broad spectrum antibiotic
3.CHRONIC PLAQUE TYPE OR NODULAR
CANDIDIASIS:
 Characterized by a white plaque
 Replaces the older term i.e candidal leukoplakia
 Both the have the potential of malignant transformation

4.DENTURE STOMATITIS:
 Most prominent in denture bearing hard palate
 Three types: -type I is localized to minor erythematous
sites caused by trauma from dentures
 Type II affect a major part of the denture covering
mucosa
 Type III have the features of type II along have
additional features i.e it has a granular mucosa in the
central part of the palate

4.ANGULAR CHELITIS:
 It is infected fissures of commissures of the mouth
 Candida and staphylococcus aureus are involved in it
 Vitamin B12 and iron deficiencies are associated with it
6.MEDIAN RHOMBHOID GLOSSITIS:
 Erythematous lesion in the center of the posterior part of
the dorsum of the tongue.
 Resulting from atrophy of filiform papilla.
