Oral Kandidoz

Öz

Oral kandidiyazis veya oral kandidoz, ağız boşluğunun en yaygın, fırsatçı, fungal enfeksiyonlarından biridir. Candida, sağlıklı bireylerin normal ağız florasında mevcuttur. Candida albicans insanlarda hem sağlıklı ağız mukozasında hem de Oral kandidoz'da bulunan en yaygın Candida türüdür. Oral dokuları Candida enfeksiyonuna duyarlı hale getiren çeşitli predispozan faktörler bulunmaktadır. Bu durumun erken teşhisi ve ağız hijyeninin sağlanması çok önemlidir. Oral kandidozun klinik görünümü, çeşitli alt tiplerle birlikte, beyaz veya eritematöz kandidoz olarak sınıflandırılabilir. Bu patolojinin tedavisi için çeşitli yaklaşımlar tanımlanmıştır. Tedaviler uygun ağız hijyeni, topikal ajanlar ve sistemik ilaçları içermektedir. Bu derlemede oral kandidoz etyolojisi, predispozan faktörler, klinik görünümü, teşhis ve tedavisinden bahsedilecektir.

Anahtar Kelimeler

• Oral kandidiyazis
• Oral kandidoz
• Candida albicans
• Fungi
• Oral flora

Oral Candidiasis

Öz

Oral candidiasis or oral candidosis is one of the most common, opportunistic, fungal infection of the oral cavity. Candida is found in the normal oral flora of healthy persons. Candida albicans is the most common Candida species found in humans both in healthy oral mucosa and oral candidosis. There are several predisposing factors that make oral tissues susceptible to Candida infection. Early diagnosis of oral candidosis and good oral hygiene are very important. The clinical presentation of oral candidosis can be classified as white or erythematous candidosis, with several subtypes. Various approaches have been described for the treatment of this pathology. Treatments include good oral hygiene, topical agents, and systemic medications. In this review, the etiology, predisposing factors, clinical presentation, diagnosis and treatment of oral candidosis will be discussed.

Anahtar Kelimeler

• Oral candidiasis
• Oral candidosis
• Candida albicans
• Fungi
• Oral flora

Kaynakça

1. 1. Millsop JW, Fazel N. Oral candidiasis. Clin Dermatol. 2016;34(4):487-494.
2. 2. Arendorf TM, Walker DM. The prevalence and intra-oral distribution of Candida albicans in man. Arch Oral Biol. 1980;25(1):1-10.
3. 3. Singh A, Verma R, Murari M, Agrawal A. Oral candidiasis: An overview. J Oral Maxillofac Pathol. 2014;18(1):81-85.
4. 4. Zegarelli DJ. Fungal infections of the oral cavity. Otolaryngol Clin North Am. 1993;26(6):1069-1089.
5. 5. Farah CS, Lynch N, McCullough MJ. Oral fungal infections. Aust Dent J. 2010;55(1):48- 54.
6. 6. McCullough MJ , ClemonsKV, StevensDA . Molecular epidemiology of the global and temporal diversity of Candida albicans. Clin Infect Dis. 1999;29(5):1220-1225.
7. 7. Reichart PA, Samaranayake LP , Philipsen HP. Pathology and clinical correlates in oral candidiasis and its variants. Oral Dis. 2000;6(2):85-91.
8. 8. Astvad K,Johansen HK, Høiby N,Steptoe P,Ishøy T . Oropharyngeal Candidiasis in Palliative Care Patients in Denmark. J Palliat Med. 2015;18(11):940-944.

9. 9. Al-Karaawi ZM, Manfredi M,Waugh AC, McCullough MJ, Jorge J, Scully C, Porter SR . Molecular characterization of Candida spp. isolated from the oral cavities of patients from diverse clinical settings. Oral Microbiol Immunol. 2002;17(1):44-49.
10. 10. Cruz BB, Romo SA, López-Esqueda FJ ,Rosa-García E de la,HernándezRR, Sánchez- VargasLO . Oral Candida isolates andfluconazole susceptibility patterns in older Mexican women. Arch Gerontol Geriatr. 2016;65:204-210.
11. 11. Farah CS, Ashman RB, Challacombe SJ. Oral candidosis. Clin Dermatol. 2000;18(5):553-562.
12. 12. Gonsalves WC, Chi AC, Neville BW. Common Oral Lesions: Part I. Superficial Mucosal Lesions. Am Fam Physician. 2007;75(4):501-507.
13. 13. Bedair AA, Darwazeh AM,Al-Aboosi MM. Oral Candida colonization and candidiasis in patients with psoriasis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5):610-615.
14. 14. Schaller M , Borelli C , Korting HC , Hube B. Hydrolytic enzymes as virulence factors of Candida albicans.Mycoses. 2005;48(6):365- 377.
15. 15. LinumaT ,Arai Y ,Abe Y, FukumotoM, Fukui Y, Lwase T, Takebayashi T, Hirose N, Gionhaku N, Komiyama Ket al. Denture wearing during sleep doubles the risk of pneumonia in the very elderly.J Dent Res. 2015;94(3):28-36.
16. 16. SalvatoriO, PuriS, TatiS, EdgertonM. Innate Immunity and Saliva in Candida albicans-mediated Oral Diseases. J Dent Res. 2016;95(4):365-371.
17. 17. Vila T, Rizk AM, Sultan AS, Jabra-Rizk MA. The power of saliva: Antimicrobial and beyond. PLOS Pathog. 2019;15(11):e1008058.
18. 18. Khan SA, Fidel PL, Jr, Al Thunayyan A, Varlotta S, Meiller TFet al. Impaired Histatin- 5 Levels and Salivary Antimicrobial Activity against C. albicans in HIV Infected Individuals.J AIDS Clin Res. 2013;4(193).
19. 19. Tejani S, Sultan A, Stojanov I , Woo SB. Candidal carriage predicts candidiasis during topical immunosuppressive therapy: a preliminary retrospective cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(4):448-454.
20. 20. Mun M,Yap T,Alnuaimi AD,Adams GG,McCullough M. Oral candidal carriage in asymptomatic patients. Aust Dent J. 2016;61(2):190-195.
21. 21. RadM ,KakoieS,Niliye Brojeni F,PourdamghanN. Effect of Long-term Smoking on Whole-mouth Salivary Flow Rate and Oral Health. J Dent Res Dent Clin Dent Prospects. 2010;4(4):110-114.
22. 22. Farah C, Balasubramaniam R, McCullough MJ. Contemporary Oral Medicine. Switzerland: Springer, 2019. 2409 p.
23. 23. VidyaKM, Rao UK, Nittayananta W, Liu H L,Owotade FJ. Oral mycoses and other opportunistic infections in HIV: therapy and emerging problems - a workshop report. Oral Dis. 2016;22(1):158-165.
24. 24. Samaranayake LP, Keung Leung W, JinJ. Oral mucosal fungal infections. Periodontol 2000. 2009;49(1):39-59.
25. 25. Warnakulasuriya S, Tilakaratna WM. Oral Medicine & Pathology: A Guide to Diagnosis and Management.Jaypee Brothers Medical Publishers,2021.
26. 26. GasparotoTH, Oliveira CE de, Vieira NA, Porto VC, Gasparoto CT, Campanelli AP, Lara VS et al. The pattern recognition receptors expressed on neutrophils and the associated cytokine profile from different aged patients with Candida-related denture stomatitis. Exp Gerontol. 2012;47(9):741-748.
27. 27. Johnson DA, Yeh CK , Dodds MW. Effect of donor age on the concentrations of histatins in human parotid and submandibular/sublingual saliva. Arch Oral Biol. 2000;45(9):731-740.
28. 28. Villa T, Sultan AS,Montelongo-Jauregui D,Jabra-Rizk MA. Oral Candidiasis: A Disease of Opportunity. J fungi (Basel, Switzerland). 2020;6(1):15.
29. 29. Apkan A, Morgan R. Oral candidiasis. Postgrad Med J. 2002;78(922):455-459.
30. 30. Sharon V, Fazel N. Oral candidiasis and angular cheilitis. Dermatol Ther. 2010;23(3):230-242.
31. 31. Muzyka BC. Oral fungal infections. Dent Clin North Am. 2005;49(1):49-65.
32. 32. Sitheeque MAM, Samaranayake LP. Chronic hyperplastic candidosis/candidiasis (candidal leukoplakia). Crit Rev Oral Biol Med. 2003;14(4):253-267.
33. 33. Patton LL. Oral lesions associated withhuman immunodeficiency virus disease. Dent Clin North Am. 2013;57(4):673-698.
34. 34. Ellepola AN, Samaranayake LP. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis. 2001;7(4):211-216
35. 35. Ellepola AN, Samaranayake LP. Oral candidal infections and antimycotics. Crit Rev Oral Biol Med. 2000;11(2):172-198.
36. 36. Giannini PJ, Shetty K V. Diagnosis and management of oral candidiasis. Otolaryngol Clin North Am. 2011;44(1):231-240.
37. 37. Barros SP, Altarawneh S, Bencharit S, Loewy Z, Gendreau L, Offenbacher S, Denture sore mouth. A possible etiology. British Dental Journal. 2012;1(12):357-360.
38. 38. Perić M, Živković R, Milić Lemić A, Radunović M, Miličić B, Arsić Arsenijević V. The severity of denture stomatitis as related to risk factors and different Candida spp. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;126(1):41-47.
39. 39. Redman RS. Prevalence of geographic tongue, fissured tongue, median rhomboid glossitis, and hairy tongue among 3,611 Minnesota schoolchildren. Oral Surgery, Oral Med Oral Pathol. 1970;30(3):390-395.
40. 40. Appleton SS. Candidiasis: pathogenesis, clinical characteristics, and treatment. J Calif Dent Assoc. 2000;28(12):942-948.
41. 41. Rose JA. Folic-acid deficiency as a cause of angular cheilosis. Lancet (London, England). 1971;2(7722):453-454
42. 42. Odden K, Schenck K, Koppang H, Hurlen B. Candidal infection of the gingiva in HIVinfected persons. J Oral Pathol Med. 1994;23(4):178-183.
43. 43. Velegraki A, Nicolatou O, Theodoridou M, Mostrou G, Legakis NJ.Paediatric AIDS-- related linear gingival erythema: a form of erythematous candidiasis? J Oral Pathol Med. 1999;28(4):178-182.
44. 44. Taylor M, Raja A. Oral Candidiasis. StatPearls. Published online July 25, 2021. Accessed September 11, 2021. https://www.ncbi.nlm.nih.gov/books/NBK545 282/
45. 45. Williams DW, Lewis MA. Isolation and identification of Candida from the oral cavity. Oral Dis. 2000;6(1):3-11.
46. 46. COMPAGNONI MA, SOUZA RF, MARRA J, PERO AC, BARBOSA DB. Relationship between Candida and nocturnal denture wear: quantitative study. J Oral Rehabil. 2007;34(8):600-605.
47. 47. Kauffman CA, Jones PG. Candidiasis.Post Grad Med. 2016;80(1):129-134.
48. 48. Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, Filler SG, Fisher JF, Kullberg BJ, Ostrosky- Zeichner L, Reboli AC, Rex JH, Walsh TJ, Sobel JD. Clinical Practice Guideline for the Management of Candidiasis: Clin Infect Dis.2009; 48(5): 503–535.
49. 49. Balabanova M, Popova L, Tchipeva R. Dyes in dermatology. Clin Dermatol. 2003;21(1):2-6.
50. 50. Epstein JB. Antifungal therapy in oropharyngeal mycotic infections. Oral Surg Oral Med Oral Pathol. 1990;69(1):32-41.
51. 51. Greenspan D. Treatment of oropharyngeal candidiasis in HIV-positive patients. J Am Acad Dermatol. 1994;31(3):51-55.
52. 52. Hellfritzsch M, Pottegård A, Pedersen AJ, Burghle A, Mouaanaki F, Hallas J, Grove EL, Damkier P. Topical Antimycotics for Oral Candidiasis in Warfarin Users. Basic Clin Pharmacol Toxicol. 2017;120(4):368-372.
53. 53. Dias AP, Samaranayake LP, Lee MT. Miconazole lacquer in the treatment of denture stomatitis: clinical and microbiological findings in Chinese patients. Clin Oral Investig. 1997;1(1):47-52.
54. 54. Zhang LW, Fu JY, Hua H, Yan ZM. Efficacy and safety of miconazole for oral candidiasis: a systematic review and metaanalysis. Oral Dis. 2016;22(3):185-195.
55. 55. Stelzner A. F. C. Odds, Candida and Candidosis, A Review and Bibliography (Second Edition). J Basic Microbiol. 1990;30(5):382-383.
56. 56. Gupta AK, Sauder DN, Shear NH. Antifungal agents: an overview. Part I. J Am Acad Dermatol. 1994;5(1):677-698
57. 57. FDA Drug Safety Communication: FDA limits usage of Nizoral (ketoconazole) oral tablets due to potentially fatal liver injury and risk of drug interactions and adrenal gland problems | FDA. Accessed September 12, 2021. https://www.fda.gov/drugs/drug-safetyand- availability/fda-drug-safetycommunication- fda-limits-usage-nizoralketoconazole- oral-tablets-due-potentially
58. 58. Aleck KA, Bartley DL. Multiple malformation syndrome following fluconazole use in pregnancy: report of an additional patient. Am J Med Genet. 1997;72(3):253- 256.
59. 59. Barone JA, Koh JG, Bierman RH, Colaizzi JL, Swanson KA, Gaffar MC, Moskovitz BL, Mechlinski W, Van de Velde V. Food interaction and steady-state pharmacokinetics of itraconazole capsules in healthy male volunteers. Antimicrob Agents Chemother. 1993;37(4):778-784.
60. 60. Vazquez JA. Role of posaconazole in the management of oropharyngeal and esophageal candidiasis. Ther Clin Risk Manag. 2007;3(4):533-542.