Candidiasis: Most common oppotunistic infection

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candidal growth in oral micro flora & its characteristic features.

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Candidiasis: Most common oppotunistic infection

  1. 1. /IINVESTIGATION FORINVESTIGATION FOR CANDIDIASISCANDIDIASIS Dr UshaDr Usha
  2. 2. CONTENTS :- 1. Definition 2.Classification 3. Clinical features and Differential Diagnosis 4. Investigation for candiasis 5. Conclusion 6. references
  3. 3. CANDIDIASIS It is multiplicity of disease caused by yeast like fungi C. Albicans -Most common oral manifestation -Other species……
  4. 4. Classification:- 1.Acute Pseudomembranous Atrophic (Antibiotic sore mouth ) 2.Chronic Atrophic -Denture stomatitis (type I& II) -Median rhomboid glossitis -Angular chelitis cotinue……
  5. 5. Hyperplastic Denture stomatitis (papillary type) Median rhomboid glossitis (nodular type) Candidal leukoplakia Multifocal 3.Mucocutaneous Syndrome associated Localized /Generalized 4.Immunocompromised state
  6. 6. Predisposing Factors. The following predisposing factors for oral candidiasis have been defined by clinical observation: 1. Marked changes in oral microbial flora (due to the use of antibiotics [especially broad-spectrum antibiotics], excessive use of antibacterial mouth rinses, or xerostomia). 2. Chronic local irritants (dentures and orthodontic appliances) 3. Administration of corticosteroids (aerosolized inhalant and topical agents are more likely to cause candidiasis than systemic administration)
  7. 7. 4. Poor oral hygiene 5. Pregnancy 6. Immunologic deficiency — congenital or childhood (chronic familial mucocutaneous candidiasis ± endocrine candidiasis syndrome [hypoparathyroidism, hypoadrenocorticism], and immunologic immaturity of infancy) — acquired or adult (diabetes, leukemia, lymphomas, and AIDS) — iatrogenic (from cancer chemotherapy, bone marrow transplantation, and head and neck radiation) 7. Malabsorption and malnutrition
  8. 8. CLINICAL FEATURES:- 1.Acute pseudomembranous candidiasis -Patchy white plaques or flecks on mucosal surface.
  9. 9.  - can be scraped – leave area of erythema.  Painful lesion .  Rapid onset of bad taste and loss of taste  Burning sensation of mouth and throat. Differential diagnosis- food debris habitual cheek biting
  10. 10.  Acute atrophic candidiasis  presents as a red patch of atrophic  or erythematous raw and painful mucosa, with minimal evidence  of the white pseudomembranous . Antibiotic sore mouth- a common form of atrophic candidiasis  symptoms of oral burning, bad taste, or sore throat during  chronic iron deficiency anemia
  11. 11. ACUTE ATROPHIC CANDIDIASIS
  12. 12. CHRONIC ATROPHIC CANDIDIASIS DENTURE STOMATITIS (DENTURE SORE MOUTH)  .
  13. 13. Three clinical stages :-  First stage consists of numerous palatal petechiae The second stage displays a more diffuse erythema involving most (if not all) of the denture-covered mucosa  The third stageincludes the development of tissue granulation or nodularity(papillary hyperplasia) commonly involving the central areas of the hard palate and alveolar ridges
  14. 14.  ANGULAR CHELITIS:-
  15. 15.  MEDIAN RHOMBOID GLOSSITIS
  16. 16.  Erythematous patches of  atrophic papillae located in the central area of the dorsum more nodular, the condition is referred to as hyperplastic median rhomboid
  17. 17.  CHRONIC HYPERPLASTIC CANDIDIASIS:-
  18. 18.  CANDIDAL LEUKOPLAKIA
  19. 19.  CHRONIC MULTIFOCAL CANDIDIASIS:-
  20. 20.  CHRONIC MUCOCUTANEOUS CANDIDIASIS:-
  21. 21. DIFFERENTIAL DIAGNOSIS  Leukoplakia  Lichan planus  chemical burns  Gangrenous stomatitis  Drug reaction  Syphilitic mucous patches
  22. 22. INVESTIGATION Final diagnosis Design treatment Plan
  23. 23. 1.CULTURE:- Sample collection – from oral scraping Imprint culture :- Sample--- Piece of foam soaked in liquid growth medium--- pressed on mucosal surface - then inoculated. Culture medium:- Sabouraud’sAgar Blood Agar Cornmeal Agar CHROMagar Pagano-Levin Agar
  24. 24. Inoculation At 37. For 48-72 hr Creamy white colonies, flat or hemispherical in shape ( Beer like aroma in sabouraud’s agar)
  25. 25. 2.MICROSCOPIC EXAMINATION BY DIFFERENT STAINING:- ----Heat fixed smear is prepared Staining by :- 20% kOH Gram staining Periodic acid-Schiff stain Brown and brenn stain Gomoris methanamine silver
  26. 26.  3. HISTOPATHOLOGIC EXAMINATION:- Biopsy specimen fixing with 10% formalin + staining examination hyphal penetration down to spinous cell layer, may invade entire epithelium, connective tissue.
  27. 27. 4.HUMAN SALIVARY MUCIN INVESTIGATION:- MUC7-12-mer-L and 12-mer-D peptide ---- show potent antifungal activity ---- Their level is detected.
  28. 28.  5.Rapid identification by DNA probe:-  - species specific probes are used to differentiate  C. dubliniesis  .
  29. 29.  6.RAPID IDENTIFICATION BY ORAL RINSE SOLUTION:- Rinsing of mouth with 10 ml of sterile phosphate buffered saline Collect saliva after 1min. Centrifuge for 10 min.
  30. 30.  Incubation in serum at 37.C for 3 hr.  Germ tubes are seen.
  31. 31. 7. IDENTIFICATION BY SPECIFIC PROBES:- -By polynucleotide and Oligonucleotide probes.
  32. 32.  8.ELECTROPHORESIS & WESTERN BLOT TECHNIQUE:- Sodium dodecyl SO4 -2 polyacrylamide gel electrophoresis & western blot demonstrate outer cell wall layer of candida

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