Clinical Features of Oral Candidiasis

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All Candida species form the same type of oral lesions clinically (Redding, 2001).

However, recent evidence suggests that mixed infections with more than one species may be associated with more severe symptoms and are more difficult to treat (Redding et al., 2002). There are three main clinical variants of oral candidiasis: the pseudomembranous (also known as thrush), the hyperplastic, and the erythematous (Axell et al., 1997). The hyperplastic form is accompanied by extensive epithelial hyper-plasia and hyperkeratosis, also termed can-didal leukoplakia. The erythematous form has been the predominant clinical form in HIV+ patients with CD4+ lymphocytes >400, whereas as the lymphocyte counts drop, the lesions appear to become more of the pseudomembranous type (Weinert et al.,

1996). Frequently all three forms coexist and the term "multifocal candidiasis" is used to describe the lesions. Candida is also frequently responsible for inflammatory lesions found between the lips (angular cheilitis), under dentures (denture stomatitis), and on the dorsal surface of the tongue (median rhomboid glossitis). Symptoms associated with this infection are pain, burning mouth, and dysphagia, which can lead to poor nutrition and significant patient morbidity (Fotos and Hellstein, 1992).

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