2. Candidiasis
• A fungal infection commonly caused by
Candida albicans
• It usually occurs in the mouth and
pharynx, but may also occur in the
esophagus
• Candidiasis can become a source of
systemic dissemination, particularly in
high-risk persons
4. • More common with immunosuppression
from disease states or treatment
regimens
– HIV infection, chemotherapy, corticosteroids
• Altered oral environment from loss of
epithelial layer, antibiotic therapy,
preexisting infections, poor oral hygiene
or nutritional status, wearing dentures
6. • Oral discomfort, burning, altered taste,
erythema
• White, raised, painless plaques, loosely
adherent
• Possible spread to the esophagus with
pain on swallowing and chest pain
8. • Microscopic smear of plaques shows
characteristic hyphae
• Fungal culture positive for C. albicans
• Occasionally, biopsy of lesions may be
necessary to rule out leukoplakia
(premalignant plaques).
10. • Topical antifungal agents in oral rinses,
troches, or creams
– clotrimazole (Mycelex)
– nystatin
• Systemic treatment is indicated if topical
agents fail or for esophageal cases with
fluconazole (Diflucan), ketoconazole
(Nizoral), or amphotericin B (Fungizone)
11. • Analgesics for pain
• Oral prostheses are also treated to
avoid harboring and reintroducing
infection
15. Attaining Adequate Nutrition
• Administer analgesics, as prescribed, 30-
60 min before meals.
• Provide soft foods, soothing liquids; avoid
temperature extremes.
• Encourage saline and sodium bicarbonate
rinses as prescribed.
• Provide gentle suctioning if pain becomes
so severe that patient cannot handle
secretions, and provide I.V. fluids.
16. Ensuring Adequate Therapy
• Administer antifungal agents as prescribed
• Observe the patient for proper use of
topical preparation.
– Make sure that mouth is clean and free of food
debris before administering drug.
– For swish-and-swallow preparations, tell the
patient to swish and hold in mouth for at least 5
minutes (preferably 20 minutes) before
swallowing.
– For troches, have the patient suck until
dissolved, more than 20 minutes.
17. • Observe for signs and symptoms of
systemic drug adverse effects: nausea;
vomiting; diarrhea; renal, bone marrow,
cardiovascular, hepatic, or neurologic
toxicities
• Explain the importance of continuing
therapy for duration prescribed, usually at
least 3 weeks.
