Oral candidiasis, or oral thrush "can be" used as pathognomonic diagnosis of human immunodeficiency. Taken from Mandell, Douglas, and Bennett's Principles & Practice of Infectious Diseases. Copyrights belong to owner. Educational purposes only.

1. Fadel Muhammad Garishah
Diponegoro Medical School
To be a medical research institution 2012

2. World Health Organization HIV/AIDS Staging

3.  Primary HIV infection has been associated
with severe aphthous stomatitis and with
oropharyngeal and esophageal candidiasis.
 Candida infections of the hard and soft
palates, buccal mucosa, tongue, pharynx, and
hypopharynx are observed frequently.

4. pharynx, and hypopharynx
hard and
soft palates
tongue
buccal mucosa

5.  Fungi kingdom; Opportunistic fungi
 Candida albicans is the species most
commonly identified, but Candida
tropicalis, Candida glabrata, and Candida
krusei infections also occur.

6.  Systemic Candida infections due to defects in
phagocyte function and number
 Mucosal Candida infections result from
impaired cellular immunity.
 Particularly as CD4+ lymphocyte counts fall
below 200 to 300/omm3.
 An opportunistic infection, it is predictive of
the disease progression and development of
other AIDS-related infections.

7. Candida albicans induces a T helper 1 (TH1) and TH17 cell-mediated immune response
that is essential to clear the fungi.

8.  Generally cottage cheese plaques that can
be removed with a tongue blade are seen on
the soft palate, tonsils, and buccal mucosa
 Atrophic candidiasis: erythematous plaques
distrib-uted in the same way as the
pseudomembranous form of the disease but
without the characteristic white exudate.
 Underdiagnosed by clinicians

9.  Candida can cause a nonscrapeable white
plaque similar to that in hairy leukoplakia
(hypertrophic candidiasis).
 Leukoplakia: corrugated lesions and hairlike
projections, candidal lesions are smooth.

10.  Candida infection of the lateral lip (angular
cheilitis) is another common complication.

11.  Physical examination,
 Potassium hydroxide (KOH) preparation
(scraped material from a plaque),
 The response to antifungal therapy establish
the diagnosis.

12.  Wide use of oral triazole antifungal agents -
emergence of disease caused by drug-resistant
fungi
 Patients treated with HAART, rates of flu-
conazole resistance were relatively low, even
though many had received several previous
courses of fluconazole, suggesting that
advanced immunosuppression is the most
important risk factor for resistance
 Some species, C. krusei and C. glabrata, are
frequently less sensitive to fluconazole.