Biomedical Engineering Reference
In-Depth Information
may involve any mucosal area, be localized, or be disseminated throughout
the entire oral cavity. Symptoms are uncommon and when present, are
rather mild with no constitutional counterpart. The most frequently reported
symptoms are a sore mouth, a burning sensation, or a bad taste.
The prevalence of
Pseudomembranous candidiasis
is approximately
5-7% among children, 10% among elderly debilitated hospital patients
and as high as 50 to 97% in HIV-immunocompromised patients (Bhayat et
al. 2010, Magalhães et al. 2001). Patients with advanced tuberculosis and
cancer are also particularly vulnerable to developing pseudomembranous
candidiasis. As previously mentioned, acute iatrogenic candidiasis may
follow broad-spectrum antibiotic therapy and intra-oral use of topical
steroids (Singh 2001).
Erythematous Candidiasis
This clinical type is primarily characterized by a painful, reddened
mucosa
(Fig. 2b)
with minimal or no white components (Gonsalves et al.
2008, Singhi and Deep 2009). The acute form is suspected when a patient
complains of a sore or burning mouth while convalescing from an illness
treated by broad-spectrum antibiotics. The dorsal surface of the tongue
will usually show a diffuse patchy loss of the fi liform papillae resulting
in a reddened bald appearance.
Median rhomboid glossitis is a chronic and asymptomatic erythematous
form of candidiasis that features a well-delineated central papillary atrophy
of the midline posterior dorsal part of the tongue. Some patients will develop
a corresponding erythematous lesion on the palatal mucosa because of
the continual contact with the tongue lesion. Angular cheilitis is also a
chronic erythematous form of oral candidiasis that produces reddening
and cracking of the skin at the corners of the mouth (Akpan and Morgan
2002, Gonsalves et al. 2008).
Chronic Hyperplastic Candidiasis (CHC)
Chronic hyperplastic candidiasis (CHC), also known as candidal
leukoplakia, predominantly affects middle-aged adults (Scardina et al.
2009). Clinically, the primary features are white nodular or plaque-like
adherent lesions that cannot be scraped or wiped from the mucosal
surfaces (Fig. 2c). Thickness varies and some lesions display a rough or
leathery texture (Resnick et al. 1990). The buccal, vestibular and labial
mucosa and the tongue are the most commonly affected sites in the oral
cavity. These lesions are clinically indistinguishable from leukoplakia.
Ultrastructural analysis reveals that
C. albicans
penetrates the epithelial
