Fungal Infections Of Oral Cavity Important Question And Answers

Fungal Infections Of the Oral Cavity

Question. Enumerate fungal lesions of oral cavity. Describe clinical features, histopathology and investigation of oral candidiasis.
Or
Write note on moniliasis.
Or
Describe in brief moniliasis.
Or
Write short note on candidiasis.
Or
Write short note on oral candidiasis.

Answer. Enumeration of fungal lesion of oral cavity

Fungal lesions affcting oral tissues are:

• Candidiasis
• Coccidioidomycosis
• Histoplasmosis
• Blastomycosis
• Paracoccidioidomycosis
• Sporotrichosis
• Chromomycosis and phaeomycotic abscess
• Aspergillosis
• Cryptococcosis
• Zygomycosis
• Mycetoma.
  • Candidiasis is a disease caused by the fungus called as Candida albicans.
  • Oral involvement is probably most common manifestation.

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Etiology

• Hormonal disturbances
• Local or systemic steroid therapy
• Xerostomia
• Poor oral hygiene
• Denture wearing
• Heavy smoking
• Prolong antibiotic therapy.
• Nutritional deficiency, e.g. vitamin A and vitamin B6.

Clinical Features

• Common sites are roof of mouth, retromolar area and mucobuccal fold.
• It is more common in women.
• Prodromal symptom is rapid onset of bad taste. Spicy food causes discomfort.
• There is presence of inflmmation, erythema and painful eroded areas may be associated with this disease.
• White patches of candidiasis are easily wiped out with wet gauge which leaves erythematous area or atrophic area.
• Deeper invasion by the organism leaves an ulcerative lesion upon removal of patch.

1. Acute Pseudomembranous Candidiasis

• Common sites are roof of mouth, retromolar area and mucobuccal fold.
• It is more common in women.
• Prodromal symptom is rapid onset of bad taste. Spicy food causes discomfort.
• There is presence of inflmmation, erythema and painful eroded areas may be associated with this disease.
• White patches of candidiasis are easily wiped out with wet gauge which leaves erythematous area or atrophic area.
• Deeper invasion by the organism leaves an ulcerative lesion upon removal of patch.

2. Acute Atrophic Candidiasis

• It can be seen anywhere in the oral cavity but most commonly site involved are tongue as well as the tissue underlying prosthesis.
• It appears as an erythematous area.
• Patient complains of burning sensation in lesional area along with vague pain.

3. Chronic Hyperplastic Candidiasis

• Male predilection is seen.
• Most common in heavy smokers.
• Oral sites involved are tongue, cheek and lips.
• There is presence of fim and white leathery plaques.
• Lesion cannot be rubbed with the lateral pressure.
• Lesion is whitish or creamy whitish in color. Borders of the lesion are vague.

Histopathology

• Epithelium show increase thickness of parakeratin at lesional area in conjunction with elongation of rete ridges.
• Small collection of neutrophils, i.e. microabscess is seen in parakeratin layer and superficial spinous layer.
• Hyphae or mycelia and yeast cells are seen in parakeratin layer of epithelium.
• There is presence of chronic inflammatory infiltrate cells such as lymphocytes and plasma cells immediately subjacent to infected epithelium.

Treatment

• Topical and systemic administration of nystatin is done.
• In immunosuppressed patients systemic administration of amphotericin B and fluconazole is given.
• Improvement of oral hygiene is essential.