![]() ![]() The genus Candida is a highly heterogeneous group of yeast-like fungi which markedly differ in their biochemical, morphological, and genetic composition. Candida albicans is the species most encountered in health subjects and infection. ![]() Only the first three are commonly isolated from oral clinical infections. The commonly isolated species are Candida albicans, C. The mere isolation of any of the Candida species from the oral cavity of a subject without the presence of clinical signs and symptoms of infection is described as “ Candida carriage.” The epidemiological studies have shown that limited Candida species were able to colonize the mouth (and other body surfaces such as skin, vagina, and gastrointestinal mucosa) of human being. Oral Candida “Carriage” versus “Infection” This paper is discussing the various reasons facilitating the recurrence or treatment failure of oral candidiasis. Therefore, it is essential for the oral candidal infection to be diagnosed accurately and managed appropriately to avoid its recurrence or systemic spread. If the superficial oral candidal infection was not well managed in severe immunosuppression, the patient may become susceptible to esophageal spread of infection or to the potentially lethal systemic candidemia. This raises the question whether the “recurrence” is a second infection or due to “persistent” Candida cells. One study estimated that around 20% of patients with oral candidiasis experience infection recurrence and in around 30% of the recurrences the second isolate was different from that responsible for the first episode of infection. It is not uncommon to encounter a recurrence of the oral candidal infection after some time of institution of antifungal therapy, which constitutes a frustration and disappointment for both the clinician and the patient. Candida albicans is the species largely responsible for oral candidiasis which is the most common human fungal infection especially in childhood and the elderly. Knowing that the majority of the species cannot live at the human body temperature explains why the oral cavity is colonized with only a limited number of Candida species.Ĭandida species constitute part of the oral harmless commensal flora in about 2–70% of the general population but is responsible for causing infection if the host immune barriers are breached either on the local or on the systemic level. The genus Candida comprised more than 150 species which are widely spreading in the environment. Oral candidal colonization and candidiasis have recently received increased attention by the health care providers and researchers alike, particularly following the emergence of human immunodeficiency virus (HIV) infection and the widespread use of broad spectrum antibiotics and immunosuppressant therapy. The oral health care provider should be aware of these fall pits in order to successfully manage oral candidiasis. ![]() Failure to properly treat oral candidiasis will lead to persistence of the fungal cell in the oral cavity and hence recurrence of infection. The unsuccessful management of oral candidiasis can due to either incorrect diagnosis, failure to identify (or correct) the underlying predisposing factor(s), or inaccurate prescription of antifungal agents. ![]() Historically, oral candidiasis has been branded as disease of diseased. Clinical oral Candida infection (candidiasis) is one of the common oral mucosal infections, and its management is usually frustrating due to either treatment failure or recurrence. ![]()
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