1/29. Successful treatment of fluconazole-resistant oropharyngeal candidiasis by a combination of fluconazole and terbinafine.Increasing incidence of resistance to conventional antifungal therapy has demanded that novel therapies be introduced. Recent in vitro studies have shown that combinations involving azoles and allylamines may be effective in inhibiting fluconazole-resistant fungi. In this report, we describe the case of a 39-year-old woman who presented with white patches on her buccal mucosa, tongue, and palate with a bright erythematous erosive base. A fungal culture revealed candida albicans. The patient failed to respond to the initially prescribed fluconazole therapy. Failure of therapy can be attributed to a developed resistance to fluconazole from the patient's intermittent use of this antifungal agent at varying dosages for the preceding 2 years due to a diagnosis of onychomycosis. in vitro testing of the culture from the patient showed elevated MICs of fluconazole, itraconzole, and terbinafine (MICs were 32, 0.5, and 64 microg/ml, respectively). Our goal was to combine therapies of fluconazole and terbinafine in an attempt to clear the fungal infection. Impressively, this combination resulted in the clearing of the clinical symptoms and the patient has successfully been asymptomatic for more than 12 months posttreatment.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
2/29. Topical azathioprine in the combined treatment of chronic oral graft-versus-host disease.This paper presents the first report of the use of topical azathioprine in the management of persistent symptomatic chronic oral graft-versus-host disease (GVHD). Topical azathioprine suspension was used as an oral rinse and was swallowed, maintaining the previously prescribed systemic dose of azathioprine, and resulted in improvement in a case of oral GVHD that was resistant to other approaches to management. Topical azathioprine may provide additional therapy in the management of immune-mediated oral mucosal disease. Clinical trials appear warranted based upon the results of topical azathioprine use as presented in this case report.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
3/29. Strain persistence of invasive candida albicans in chronic hyperplastic candidosis that underwent malignant change.OBJECTIVES: The aim of this study was to assess persistence and tissue invasion of candida albicans strains isolated from a 65 year-old patient with chronic hyperplastic candidosis (CHC), that subsequently developed into squamous cell carcinoma (SCC). MATERIALS AND methods: C. albicans (n=7) were recovered from the oral cavity of the patient over seven years. Confirmation of CHC and SCC in this patient was achieved by histopathological examination of incisional biopsy tissue. dna fingerprinting was performed on the seven isolates from the CHC patient together with a further eight isolates from patients with normal oral mucosa (n=2), chronic atrophic candidosis (n=1), SCC (n=1) and CHC (n=4). Genotyping involved the use of inter-repeat PCR using the eukaryotic repeat primer 1251. Characterisation of the tissue invasive abilities of the isolates was achieved by infecting a commercially available reconstituted human oral epithelium (RHE; SkinEthic, Nice, france). After 24 h, C. albicans tissue invasion was assessed by histopathological examination. RESULTS: dna fingerprinting demonstrated strain persistence of C. albicans in the CHC patient over a seven year period despite provision of systemic antifungal therapy. The strain of C. albicans isolated from this patient was categorised as a high invader within the RHE compared to other isolates. CONCLUSIONS: Candidal strain persistence was evident in a patient with CHC over seven years. This persistence may be due to incomplete eradication from the oral cavity following antifungal therapy or subsequent recolonisation from other body sites or separate exogenous sources. The demonstration of enhanced in vitro tissue invasion by this particular strain may, in part, explain the progression to carcinoma.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
4/29. fluconazole for postpartum candidal mastitis and infant thrush.This case report illustrates the difficulties inherent in treating candidal mastitis in lactating women and concurrent thrush in the breastfeeding baby. This mother's candidiasis vacillated from topical to ductal, depending on which medications were being used over the course of several months. Her baby's oral thrush was unique in that there were never any white plaques visible on his oral mucosa. Ultimately, both mother and child were treated simultaneously with oral fluconazole, with a relief of symptoms in both individuals.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
5/29. Pseudomembranous candidosis in nephrotic syndrome: a case report.A 33-year-old male presented for evaluation of several large, recently discovered white oral lesions of unknown duration. Clinical examination revealed multiple white plaques on the soft palate, uvula, buccal mucosa, and tongue. These lesions could be wiped away, leaving an erythematous base. The lesions were asymptomatic, and the patient did not report difficulty in swallowing. The patient's medical history was noteworthy for several significant diagnoses within the previous 6 months: type 2 diabetes mellitus, mild systolic hypertension, gastroesophageal reflux disease, and adult idiopathic nephrotic syndrome, determined by kidney biopsy to be caused by focal segmental glomerulosclerosis. A provisional diagnosis of pseudomembraneous candidosis was made, and the patient responded to a 14-day course of clotrimazole, administered in 10-mg troches, five times a day. Management of nephrotic syndrome predisposes patients to recurrent fungal infections, and the disease has implications for the selection of systemic antifungal agents.- - - - - - - - - - ranking = 1.0059051604564keywords = mucosa, membrane (Clic here for more details about this article) |
6/29. Disseminated American muco-cutaneous leishmaniasis caused by leishmania braziliensis braziliensis in a patient with AIDS: a case report.The authors report a case of culture-proven disseminated American muco-cutaneous leishmaniasis caused by leishmania braziliensis braziliensis in an hiv positive patient. Lesions began in the oropharynx and nasal mucosa eventually spreading to much of the skin surface. The response to a short course of glucantime therapy was good.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
7/29. Chronic mucocutaneous candidiasis: a case report.Chronic mucocutaneous candidiasis is a immuno deficiency disorder primarily due to T cell dysfunction characterized by persistent candidal infection of mucous membrane, skin, scalp and nails. Chronic mucous membrane candidiasis has an onset in infancy or childhood; the primary affected site is the oral cavity; however, lesions may occur on trunk, hands, feet and scalp. This paper describes a 12-year-old girl with candidial infection of the oral mucosa and extra oral involvement of fingers, nails, toes and intertragus area.- - - - - - - - - - ranking = 1.0118103209127keywords = mucosa, membrane (Clic here for more details about this article) |
8/29. oral manifestations during chemotherapy for acute lymphoblastic leukemia: a case report.A 14-year-old, male patient was referred for the treatment of mucositis, idiopathic facial asymmetry, and candidiasis. The patient had been undergoing chemotherapy for 5 years for acute lymphoblastic leukemia. He presented with a swollen face, fever, and generalized symptomatology in the mouth with burning. On physical examination, general signs of poor health, paleness, malnutrition, and jaundice were observed. The extraoral clinical examination showed edema on the right side of the face and cutaneous erythema. On intraoral clinical examination, generalized ulcers with extensive necrosis on the hard palate mucosa were observed, extending to the posterior region. Both free and attached gingivae were ulcerated and edematous with exudation and spontaneous bleeding, mainly in the superior and inferior anterior teeth region. The tongue had no papillae and was coated, due to poor oral hygiene. The patient also presented with carious white lesions and enamel hypoplasia, mouth opening limitation, and foul odor. After exfoliative cytology of the affected areas, the diagnosis was mixed infection by candida albicans and bacteria. Recommended treatment was antibiotics and antifungal administration, periodontal prophylaxis, topical application of fluor 1.23%, and orientation on and control of proper oral hygiene and diet during the remission phase of the disease.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
9/29. Effect of low-level laser therapy on candida albicans growth in patients with denture stomatitis.OBJECTIVE: The purpose of our report is to present the effect of low-level laser therapy on candida albicans growth and palatal inflammation in two patients with denture stomatitis. BACKGROUND DATA: The most common oral mucosal disorder in denture wearers is denture stomatitis, a condition that is usually associated with the presence of the yeast candida albicans. Different treatment methods have been suggested to treat this symptom, none of which is proven to be absolutely effective. methods: Two denture-wearing patients, both with palatal inflammation diagnosed as Newton type II denture stomatitis were treated with low-power semiconductor diode laser (BTL-2000, Prague, czech republic) at different wavelengths (685 and 830 nm) for 5 d consecutively. In both patients, palatal mucosa and acrylic denture base were irradiated in noncontact mode (probe distance of 0.5 cm from irradiated area) with different exposure times-5 min (830 nm, 3.0 J/cm2, 60 mW) and 10 min (685 nm, 3.0 J/cm2, 30 mW). The effect of laser light on fungal growth in vivo was evaluated after the final treatment using the swab method and semiquantitative estimation of candida albicans colonies growth on agar plates. The severity of inflammation was evaluated using clinical criteria. RESULTS: After lowlevel laser treatment, the reduction of yeast colonies on the agar plates was observed and palatal inflammation was diminished. CONCLUSION: LLLT is effective in the treatment of denture stomatitis. Further placebo controlled studies are in progress.- - - - - - - - - - ranking = 2keywords = mucosa (Clic here for more details about this article) |
10/29. Oral pemphigus vulgaris in young adults.Three patients, aged 31, 26, and 22 years, had pemphigus vulgaris. A delay in diagnosis and appropriate treatment occurred because the initial presentation was confined to the oral mucosa.- - - - - - - - - - ranking = 1keywords = mucosa (Clic here for more details about this article) |
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