Candida Stomatitis

Also see the chapter on Candidiasis.

Candidiasis is the most common cause of fungal infections affecting the oral mucosa.

Candida are saprophytic yeasts of the mucosal membranes that may become pathogenic due to various factors as follows:

– physiological factors: first days of life, prematurity, pregnancy;

– local factors: overgrowth of oral flora, xerostomia, changes in salivary pH (acidification), poor hygiene, local corticosteroid therapy;

– general factors: iatrogenic (treatment with antibiotics or corticosteroids and other immunosuppressant therapies, psychotropic agents, radiotherapy), endocrine disorders (diabetes, Addison’s disease, hypoparathyroidism), iron deficiency anaemia, Sjögren’s syndrome, blood diseases, HIV infection (it is a revealing sign in 20% of cases).

Candidiasis is almost always caused by the species albicans. In rare cases when other potentially pathogenic species such as C. tropicalis or C. glabrata are isolated, these  species should be imputed only if the clinical signs of candidiasis are frank, if culture gives rise to very abundant colonies and if the lesions resolve with antifungal treatment.