Oral Candidosis: Pathophysiology and Best Practice for Diagnosis, Classification, and Successful Management

Abstract

Oral candidosis is the most common fungal infection that frequently occurs in patients debilitated by other diseases or conditions. No candidosis happens without a cause; hence oral candidosis has been branded as a disease of the diseased. Prior research has identified oral candidosis as a mark of systemic diseases, such as hematinic deficiency, diabetes mellitus, leukopenia, HIV/AIDS, malignancies, and carbohydrate-rich diet, drugs, or immunosuppressive conditions. An array of interaction between Candida and the host is dynamic and complex. Candida exhibits multifaceted strategies for growth, proliferation, evasion of host defenses, and survival within the host to induce fungal infection. Oral candidosis presents a variety of clinical forms, including pseudomembranous candidosis, erythematous candidosis, angular cheilitis, median rhomboid glossitis, cheilocandidosis, juxtavermillion candidosis, mucocutaneous candidosis, hyperplastic candidosis, oropharyngeal candidosis, and rare suppurative candidosis. The prognosis is usually favorable, but treatment failure or recurrence is common due to either incorrect diagnosis, missing other pathology, inability to address underlying risk factors, or inaccurate prescription of antifungal agents. In immunocompromised patients, oropharyngeal candidosis can spread to the bloodstream or upper gastrointestinal tract, leading to potentially lethal systemic candidosis. This review therefore describes oral candidosis with regard to its pathophysiology and best practice for diagnosis, practical classification, and successful management.

Molecular Mapping of Antifungal Mechanisms Accessing Biomaterials and New Agents to Target Oral Candidiasis

“…Other lesions associated with C. albicans development target the commissures of the lips in angular cheilitis or the dorsum area of the tongue, where symmetrical disposal of the lesions determines the shaping of median rhomboid glossitis. The lesions can appear independently or in mixed pathologies associated with pseudomembranous and erythematous candidiasis and constitute a real challenge for an appropriate therapeutic purpose [ 105 ].…”

Epidemiology, prevalence, and associated factors of oral candidiasis in HIV patients from southwest Iran in post-highly active antiretroviral therapy era

“…Oral candidiasis (OC) is the most common human fungal infection, which is known as a frequent opportunistic infection in immunosuppressed patients (Vila et al, 2020). Prolonged use of broad-spectrum antibiotics, treatment with corticosteroids, xerostomia, malignancies, Sjögren's syndrome, acquired immune deficiency syndrome (AIDS), use of dentures and smoking are the predisposing factors for OC (Akpan and Morgan, 2002;Lu, 2021). Oral candidiasis is also a common infection in HIV-infected patients that is observed in more than 90% of these patients during HIV infection, especially in the early stages before highly active antiretroviral therapy (HAART) as well as in advanced stages of AIDS (Walmsley et al, 2001;Gabler et al, 2008).…”

Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications

“…Nystatin (Nys) 2 was the first macrolide polyene antimycotic to be discovered [ 22 ]; it was first called fungicidin [ 36 ] and is synthesized by Streptomyces noursei . Due to a slightly higher toxicity, Nys is used topically [ 37 , 38 , 39 , 40 ] to treat, for example, oral candidiasis [ 41 ]. Toxicity is a major problem when it comes to the clinical use of polyenes and remains an obstacle when addressing an increasing number of multidrug-resistant fungal pathogens such as Candida albicans , Candida lusitaniae [ 42 ], and Candida auris [ 43 ].…”