Oral candidiasis in Adult
See also in: Oral Mucosal LesionAlerts and Notices
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Synopsis
Risk factors include hyposalivation states leading to dry mouth (especially medication-related xerostomia and xerostomia related to head or neck radiation), antibiotic therapy, oral leukoplakia, a carbohydrate-rich diet, medications such as inhaled corticosteroids, fluid and electrolyte imbalance, smoking, diabetes mellitus, and immunosuppression. For angular cheilitis, dentures that do not adequately support the oral musculature, causing drooping of the corners of the mouth and pooling of saliva, may predispose.
Patients may complain of a sore, sensitive, or burning sensation. Itching has also less frequently been described. Others may be wholly asymptomatic.
Pseudomembranous candidiasis (thrush) usually develops fairly rapidly over a few days, while the erythematous and hyperplastic forms tend to be chronic and present for weeks or months.
Candida albicans is the most commonly implicated species in oral candidiasis. Species of Candida that are occasional causes of disease, particularly in AIDS-infected patients and patients with a history of head and neck radiation, are Candida glabrata (formerly known as Torulopsis glabrata), Candida tropicalis, Candida krusei, Candida dubliniensis, and others.
Immunocompromised patient considerations: Oral candidiasis is seen with greater frequency in patients with leukemia or other malignancies, individuals with AIDS, and individuals receiving immunosuppressive agents (eg, systemic corticosteroids, azathioprine, cyclosporine A, or tacrolimus). Patients with diabetes are also predisposed. Risk factors for oral candidiasis in the HIV-positive population include low CD4 count (< 200 cells/microl), being antiretroviral naïve, and current smoking. Laryngeal and/or esophageal involvement may occur in concert with oral candidiasis in immunocompromised patients. Isolated laryngeal involvement has been reported from inhaled corticosteroids.
Codes
B37.0 – Candidal stomatitis
SNOMEDCT:
79740000 – Oral candidiasis
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Last Updated:09/27/2023
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