Oral Candidiasis a Fictitious Report Thesis

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It is commonly associated with Staphylococcus aureus (2011). "Studies have shown that 20% of all cases are caused by Candida albicans alone, 60% are caused by a combination of Staphylococcus aureus and Candida albicans, and 20% are caused by Staphylococcus aureus alone" (2011).

Angular cheilitis can be found in any age group and can be diagnosed by an "erythematous, fissured area" (RDH 2011) are the corners of the mouth. The tissue will appear wrinkled and a "superficial crust may be seen superimposed over the affected area" (2011). Accencuated folds in the corner area of the mouth on older individuals can be a great environment for Candida albicans to thrive (2011).

The reason Candida albicans is often misdiagnosed is because an overgrowth of Candida in the human body can cause more than 100 various symptoms related to Candidiasis, making it practically impossible to pin down (Candida Cure Zone 2011). To get an idea of the havoc an overgrowth of Candida can wreak on a person's body, here is a list: gas, irritability, brain fog, low energy, chronic fatigue, headaches, indigestion, depression, eczema, depression, rectal itching, acid reflux, sweet cravings, and low sex drive (to name a few) (2011).

According to Laskaris (2004), the diagnosis of candidiasis is normally based on clinical criteria (p. 30). A direct smear microscopic examination with potassium hydroxide and culture are often helpful; Biopsy and histophathologic examination may also be required or helpful in certain cases (p. 30).

Laskaris (2004) says that there are a few basic guidelines for treating oral candidiasis. First, elimination of systematic and/or local predisposing factors are essential in order avoid a reoccurrence; secondly, maintenance of high level oral hygiene and the reduction of the Candida reservoir in the mouth, esophagus, and genitalia is required; thirdly, an accurate diagnosis of oral candidiasis is absolutely vital; next, a topical or systematic treatment needs to be used, depending on the form as well as the seriousness of the disease; lastly, the majority of the available antifungal drugs target the synthesis of ergosteroil, a constituent of the fungal cell membrane (p. 31).

In systematic treatment of oral candidiasis, systematic azoles are the best drugs, according to Laskaris (2004, p.

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31). Itraconazole capsules 100mg/day or flucanazole for acute pseudomembranous candidiasis and Candida-associated lesions (p. 31). The erythematous and nodular forms usually require therapy for 2-4 weeks (p. 31). The secondary forms need long-term administration of the above drugs in a dose of 100-200mg/day for anywhere between 1 and 3 months (p. 31). Ketaconazole capsules 200mg/2 day for 1 to 4 weeks, depending on the form of oral candidiasis, may also be utilized (p. 31). In patients who have resistant Candida species, in neutropenic patients, or in patients with malignancies, transplants, and AIDS, itraconazole oral solution 2.5-5mg/kg per day is required (p. 31). Ketoconazole has a much greater bioavailability than itraconazole and also has a topical effect; because of this, it may have additional benefits over the other oral agents in the treatment of this disease (p. 31). Laskaris notes that it must be remembered that in order to have a successful treatment, correction of the predisposing factors is vital (p. 31).

Nyastatin oral suspension 4/day or miconazole oral gel 5 ml/4 day for 1 to 2 weeks is indication, especially for oral acute pseudomembranous candidiasis in infants or children or for adults where systematic treatment isn't required (Laskaris 2004, p. 31). Angular cheilitis (perleche) is treated with topical antifungal ointments (p. 31).

There are future therapies in the works. Third generation triazoles (voriconazole, posaconazole, ravuconazole), echinocandins (main representative caspofungin) and the incorpotation of nyastatin into liposomes are being researched as possible other alternative treatments......

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