RESUMEN
Oral candidosis is the most common opportunistic fungal infection encountered in dentistry. Normally a benign inhabitant of mucous membranes, the fungal organism, Candida albicans, may present serious, even life-threatening infection in specific patient populations. As an opportunistic organism, Candida albicans is extremely responsive to any process resulting in immunosuppression. The clinical manifestations of oral candidosis are variable, occasionally complicating the clinical diagnosis and management. Treatment is often initially rendered based on a provisional clinical diagnosis and supplemented with adjunctive laboratory tests. Specific therapeutic intervention should be tailored to the individual patient, based on the current health status of the patient and the clinical presentation and severity of the infection.
Asunto(s)
Candidiasis Bucal/fisiopatología , Antifúngicos/uso terapéutico , Candida albicans/patogenicidad , Candidiasis Bucal/clasificación , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/tratamiento farmacológico , Queilitis/microbiología , Enfermedad Crónica , Eritema/microbiología , Glositis/microbiología , Humanos , Hiperplasia , Huésped Inmunocomprometido , Infecciones Oportunistas/diagnósticoRESUMEN
A 33-year-old male presented for evaluation of several large, recently discovered white oral lesions of unknown duration. Clinical examination revealed multiple white plaques on the soft palate, uvula, buccal mucosa, and tongue. These lesions could be wiped away, leaving an erythematous base. The lesions were asymptomatic, and the patient did not report difficulty in swallowing. The patient's medical history was noteworthy for several significant diagnoses within the previous 6 months: type 2 diabetes mellitus, mild systolic hypertension, gastroesophageal reflux disease, and adult idiopathic nephrotic syndrome, determined by kidney biopsy to be caused by focal segmental glomerulosclerosis. A provisional diagnosis of pseudomembraneous candidosis was made, and the patient responded to a 14-day course of clotrimazole, administered in 10-mg troches, five times a day. Management of nephrotic syndrome predisposes patients to recurrent fungal infections, and the disease has implications for the selection of systemic antifungal agents.