Oropharyngeal and Esophageal Candidiasis in Immunocompromised Patients: Treatment Issues

Darouiche, Rabih O.

doi:10.1086/516315

Cited by 110 publications

(91 citation statements)

References 19 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Oral candidiasis affects a large proportion of HIV-positive individuals and those with AIDS (Greenspan and Greenspan, 1996;Darouiche, 1998), and approximately 90% of AIDS patients have suffered from oropharyngeal or esophageal candidiasis at some stage of their illness (Alexander and Perfect, 1997) Oropharyngeal candidiasis is also often seen in the elderly, and merits investigation of potential pre-disposing factors (Shay et al, 1997). A comprehensive analysis of the literature concerning the treatment of immunocompromised patients with oropharyngeal or esophageal candidiasis indicates that optimal results are achieved with the triazoles fluconazole and itraconazole (Darouiche, 1998). They offer clinical efficacy at least comparable with that of the polyenes and imidazoles, together with a highly favorable mycological cure rate.…”

Section: Removalmentioning

confidence: 99%

“…C. dubliniensis is closely related to C. albicans (Coleman et al, 1997), and as with C. albicans, stable fluconazole resistance can be induced by exposure to the drug (Albertson et al, 1996;Moran et al, 1997). Treatment of AIDS patients with prolonged courses of azole antifungal agents appears to have selected for the development of azole-resistant C. albicans strains (White, 1997a;Darouiche, 1998). Resistance can be due to mutations in the drug target (White, 1997b;Sanglard et al, 1998) or over-expression of drug efflux pumps (Sanglard et al, 1995;Albertson et al, 1996).…”

Section: Removalmentioning

confidence: 99%

See 1 more Smart Citation

Oral Colonization By Candida Albicans

Cannon

Chaffin

1999

Critical Reviews in Oral Biology & Medicine

276

193

View full text Add to dashboard Cite

Candida albicans is a commensal yeast normally present in small numbers in the oral flora of a large proportion of humans. Colonization of the oral cavity by C. albicans involves the acquisition and maintenance of a stable yeast population. Micro-organisms are continually being removed from the oral cavity by host clearance mechanisms, and so, in order to survive and inhabit this eco-system, C. albicans cells have to adhere and replicate. The oral cavity presents many niches for C. albicans colonization, and the yeast is able to adhere to a plethora of ligands. These include epithelial and bacterial cell-surface molecules, extracellular matrix proteins, and dental acrylic. In addition, saliva molecules, including basic proline-rich proteins, adsorbed to many oral surfaces promote C. albicans adherence. Several adhesins present in the C. albicans cell wall have now been partially characterized. Adherence involves lectin, protein-protein, and hydrophobic interactions. As C. albicans cells evade host defenses and colonize new environments by penetrating tissues, they are exposed to new adherence receptors and respond by expressing alternative adhesins. The relatively small number of commensal Candida cells in the oral flora raises the possibility that strategies can be devised to prevent oral colonization and infection. However, the variety of oral niches and the complex adherence mechanisms of the yeast mean that such a goal will remain elusive until more is known about the contribution of each mechanism to colonization.

show abstract

Section: Removalmentioning

confidence: 99%

Section: Removalmentioning

confidence: 99%

Oral Colonization By Candida Albicans

Cannon

Chaffin

1999

Critical Reviews in Oral Biology & Medicine

276

193

View full text Add to dashboard Cite

show abstract

“…Increased retroviral replication and an associated decline in immune defenses render these patients particularly susceptible to OPC, to the extent that it is consider an early sign of HIV infection (Darouiche 1998). The prolonged nature of Aids predisposes these patients to recurrent episodes of OPC that can increase in frequency and severity with progressive HIV disease.…”

mentioning

confidence: 99%

Multicenter Brazilian Study of Oral Candida Species Isolated from Aids Patients

Santana

Milan

Martínez

et al. 2002

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

show abstract

“…EC requires systemic antifungal therapy [25], and it should never be managed with local agents [26]. Oral fluconazole is generally recommended for the treatment of EC due to its excellent efficacy, ease of administration and low cost [27].…”

Section: Discussionmentioning

confidence: 99%

“…In three randomized trials, fluconazole was superior to ketoconazole, flucytosine and itraconazole for the treatment of EC [28,29]. In a number of trials and smaller studies, the effectiveness of fluconazole therapy has ranged from 80% to 90% [26,30,31].…”

Section: Discussionmentioning

confidence: 99%

Esophageal Candidiasis in a Patient With Uncontrolled Diabetes Mellitus and Recurrent Abdominal Pain, Symptomatic Or Incidental? A Case Report and Brief Literature Review

2015

View full text Add to dashboard Cite

Esophageal candidiasis (EC) is a common opportunistic infection in patients with impaired cellular immunity, such as human immunodeficiency virus (HIV) infection. However, it can also be found in individuals with certain predisposing conditions like uncontrolled diabetes mellitus (DM) and the use of certain medications. We report a 54-year-old female with past medical history of DM, hypertension and hyperlipidemia who presented to the ER with worsening periumbilical and epigastric pain for 2 days. She had multiple similar presentations requiring admissions to different hospitals and had undergone extensive workup over the past year. She only had transient improvement from these hospitalizations. Esophagogastroduodenoscopy (EGD) performed on day 2 of admission revealed extensive creamy pseudomembranous exudate through the entire length of esophagus confirmed as Candida albicans by brush scraping analysis. She received oral fluconazole with significant relief of her symptoms over the next couple of weeks. Although EC remains asymptomatic in the majority of patients and is only detected incidentally on EGD, its diagnosis and treatment can provide significant symptomatic relief in many patients. EC should be considered as a potential diagnosis in the appropriate clinical setting even in patients with no evidence of overt immunodeficiency.

show abstract

Oropharyngeal and Esophageal Candidiasis in Immunocompromised Patients: Treatment Issues

Cited by 110 publications

References 19 publications

Oral Colonization By Candida Albicans

Oral Colonization By Candida Albicans

Multicenter Brazilian Study of Oral Candida Species Isolated from Aids Patients

Esophageal Candidiasis in a Patient With Uncontrolled Diabetes Mellitus and Recurrent Abdominal Pain, Symptomatic Or Incidental? A Case Report and Brief Literature Review

Contact Info

Product

Resources

About