This disease is caused by fungi of the genus Candida. It is also called candidomycosis, thrush and other names.
Candidiasis is caused by yeast-like, opportunistic fungi (Candida albicans, less often Candida tropicalis or other fungi) – aerobes that are widespread in the environment. They can be found on the surface of healthy skin and mucosa and in human body secretions. Candida albicans is part of the resident flora of the human mouth and, in 50-70% of cases, is found in small amounts in an inactive state even in patients without candidiasis.
Candidiasis is promoted by:
- Long-term use of antibiotics;
- Poor oral hygiene;
- Galvanism (different metals in the mouth at the same time);
- Suppression of local protective (immune) factors;
- Radiation therapy;
- Immunosuppressive therapy;
For diagnosis, microbiological findings are of primary importance, as is the detection of mycelial threads in samples scraped from the lesions.
Pseudomembranous, atrophic and hyperkeratotic forms of oral candidiasis are distinguished.
In the pseudomembranous form, the mucosa of the cheeks, tongue, palate and gums is affected. Sometimes the process can spread to the larynx, pharynx and esophagus. The coating comes off easily, exposing a smooth, reddened surface. The coating consists of epithelial cells, fibrin, microorganisms and yeast-like mycelium. Patients complain of burning, dryness, discomfort and sometimes pain, and saliva may be thick. Candidal cracks mainly occur in older people against a background of vitamin B deficiency and reduced bite height.
In the atrophic form, the mucosa is very red (candidal stomatitis) and sometimes slightly swollen. When the lips are affected (candidal cheilitis), the mucosa (often of the lower lip) is red and sometimes covered with whitish crusts. Candidal glossitis often appears in the folds of the tongue. Patients complain of dryness, burning and pain in the affected areas.
The hyperkeratotic form resembles the pseudomembranous form, but the coating is firmly attached to the underlying tissues, soaked with fibrin and hard to remove. Once removed, a bleeding surface is visible.
Chronic candidiasis (thrush) – in children, in neglected cases, chronic candidiasis shows up on the oral mucosa as yellow or light brown rounded growths that are tightly connected to each other and raised above the surface of the mucosa of the tongue, cheeks and palate. The mucosa is red, swollen and painful. Regional lymph nodes are swollen. The mouth becomes dry, and children are listless because of the pain.
Treatment must be comprehensive and rational. In healthy children with mild forms, local alkalizing agents that inhibit fungal growth can be used, for example rinsing the mouth with 10-15% sodium borate in glycerin or 1-2% sodium bicarbonate (baking soda). Applying nystatin powder is also a rational choice.
Treatment must be individual, because candidiasis is a secondary disease caused by reduced immune defense due to various factors.
Prevention of candidiasis lies in proper oral care. During long-term treatment with antibiotics and corticosteroids, antifungal medications should be prescribed preventively.
