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Acute Pseudomembranous Candidosis (Thrush)

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Candidosis is seen orally in people with altered oral ecology (from dental appliances,

hyposalivation, or the local use of immunosuppressants or antimicrobials) and/or impaired


immunity (eg, transplant recipients, persons on immunosuppressive treatments, persons with
HIV/AIDS or oral cancer, various cellular immune defects.
By tradition, the most commonly used classification of oral candidosis divides the infection into 4
types including (1) acute pseudomembranous candidosis (thrush), (2) acute atrophic
(erythematous) candidosis, (3) chronic hyperplastic candidosis, and (4) chronic atrophic
(erythematous) candidosis.

Acute pseudomembranous candidosis (thrush)


Thrush may be observed in apparently healthy neonates (who have not yet developed immunity)
or in persons in whom antibiotics, corticosteroids, or hyposalivation disturb the oral microflora. In
premature neonates, systemic candidosis may arise. [12]
Oropharyngeal thrush occasionally complicates the use of corticosteroid inhalers or other topical
preparations. Immune defects, especially HIV infection, immunosuppressive treatment,
leukemias, lymphomas, cancer, and diabetes, may predispose patients to candidal infection.

Erythematous candidosis
Erythematous candidosis may cause a sore red mouth, especially of the tongue, in patients
taking broad-spectrum antimicrobials. It also may be a feature of HIV disease. Median rhomboid
glossitis is a red patch occurring in the middle of the dorsum in the posterior area of the anterior
two thirds of the tongue and especially is observed in smokers and in those with HIV disease.

Chronic hyperplastic candidosis


Chronic hyperplastic candidosis typically presents as a leukoplakia often at the angles of the
mouth or on the tongue, and it has a higher malignant potential than some other leukoplakias.
This is especially the case when associated with autoimmune polyendocrinopathy-candidiasisectodermal dystrophy.[13]

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