Acute Pseudomembranous Candidiasis (Thrush)
This most frequent intraoral form of the disease in HIV negative patients is mainly seen in neonates, elderly persons and cancer patients. It is also the most frequent form seen in patients with AIDS and patients undergoing radiation therapy for various tumors. Clinically it is characterized by multiple white to yellow soft small plaques on red or normal colored mucosa.These plaques coalesce and form large pseudomembranes. The most common sites are the buccal, labial and palatal mucosa, and the lateral border and dorsal surface of the tongue. These plaques are easily removed with a gauze and they leave an erythematous desquamated area which, especially in AIDS patients, will bleed. AIDS patients may present bluish-white plaques which cover large areas of the oral mucosas. Patients complain of a burning sensation and taste alterations. This type of candidiasis is associated with the first stages of immuno suppression, with patients having a CD4+ cell count generally below 400 cells per cubic millimiter. In the photograph to the left above note the multiple whitish plaques developing on normal colored buccal mucosa. These plaques represent C. al. colonies. The colonies start as small plaques which eventually coalesce to form large areas as seen in this photo. The photo to the right shows the tongue of an HIV positive patient with large white-yellowish candidal plaques on the dorsal surface. Additionally this patient had bilateral hairy leukoplakia and candidiasis of both lateral borders of the tongue.
Therapeutic protocols
References relevant to candidiasis (with abstracts)
Acute atrophic candidiasis
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