Fluorescence staining vs. routine KOH smear for rapid diagnosis of oral candidiasis—A diagnostic test

Abstract

Objective A diagnostic test was designed to evaluate the accuracy and applicability of fluorescence staining with fluorescein‐labelled chitinase versus routine 10% potassium hydroxide (KOH) smear for rapid diagnosis of oral candidiasis. Methods In total, 124 subjects with suspected oral candidiasis symptoms/signs were sequentially enrolled in this study. The diagnostic efficacy indexes (sensitivity, specificity, Youden index, predictive value, likelihood ratio, diagnostic odds ratio, diagnostic accuracy and area under the curve [AUC]) were compared between 10% KOH smear and fluorescence staining. Results The sensitivity (85.48% vs. 64.52%) and specificity (91.94% vs. 72.58%) of fluorescence staining were higher than those of KOH smear. The AUC of fluorescence staining (0.887) was remarkably higher than that of 10% KOH smear (0.685), demonstrating that the diagnostic efficacy of fluorescence staining is significantly higher than that of KOH smear (p = .0005). Furthermore, fluorescence staining showed higher sensitivity than that of KOH smear (84.75% vs. 62.71%) in diagnosis of erythematous type oral candidiasis, which is the most common type and the type most challenging to differentially diagnose. Conclusion The advantages of fluorescence staining with fluorescein‐labelled chitinase in rapid diagnosis of oral candidiasis and its ease of operation suggest its potential use in clinical practice.

Utility of MGG and Papanicolaou stained smears in the detection of Mucormycosis in nasal swab/scraping/biopsy samples of COVID 19 patients

“…Further, detection of Mucor in 3 out of 16 repeat samples from patients previously reported as negative, highlights the need for a repeat test after an initial KOH negative test. The sensitivity and specificity of KOH mount have been studied in various fungal infections and have been reported to be 64.5% and 72.5%, respectively, for oral Candidiasis, 6 81.8% and 92.8%, respectively, for Onychomycosis 7 and 71% and 32%, respectively, for Dermatophytoses 8 . Though the method can give immediate results with minimal infrastructure requirement, it fails to identify the fungus to its genus or species level 22 .…”

“…While KOH has a rapid turnaround time, results from histopathology and culture are often delayed. Although KOH has good sensitivity, it may be supplemented with a diagnostic method which can examine these specimens and give fast and reliable results 6–8 …”

“…Although KOH has good sensitivity, it may be supplemented with a diagnostic method which can examine these specimens and give fast and reliable results. 6 , 7 , 8…”

Malignant Transformation and Treatment Recommendations of Chronic Hyperplastic Candidiasis—A Six‐year Retrospective Cohort Study

“…According to the different clinical manifestations, OC can be classified into pseudomembranous candidiasis, erythematous candidiasis and chronic hyperplastic candidiasis (CHC) 1 . Among these types, CHC is a rare type of OC, with an incidence of about 1.61% in OC patients, mainly affecting middle‐aged smoking men 2 . The prevalence of chronic hyperplastic candidiasis is around 0.5% in Chinese patients with oral candidiasis 3 .…”

Oral Microbiota Composition and Function Changes During Chronic Erythematous Candidiasis

“…Chronic erythematous candidiasis is the most common type of Oral candidiasis (Oral candidosis, OC) ( Hu et al., 2020 ), which is the most common opportunistic fungal disease occurring in oral cavity. It is estimated that 5% of newborns, 10% of elderly patients, 30-94% of individuals with malignant tumors, and nearly 90% of HIV-infected patients can develop into OC ( Davies et al., 2008 ; Poncet et al., 2009 ).…”