Candidiasis

Definisi
Kandidiasi oral : infeksi oportunistik pada rongga mulut yang disebabkan oleh pertumbuhan
berlebihan jamur Candida terutama Candida Albican.
Candida albican : melekat pada mukosa labial, mukosa buccal, dorsum lidah, dan daerah
palatum.
 Definisi
Candidiasis is a common opportunistic oral mycotic
infection that develops in the presence of one of several
predisposing conditions. Clinical presentation is variable and is
dependent on whether the condition is
acute or chronic (Box 3-5)
Epidemiologi
1. WHO Tahun 2001 Frekuensi kandidiasis oral antara 5,8 %
2. kejadian kandidiasi oral meningkat pada usia lebih dari 35 tahun.
 Etiologi
Oleh Candida Albicans, untuk spesies lainnya :
C. Parapsilosis
C. Tropicalis
C. Glabrata
C. Krusei
C. Pseudotropicalis
C. guiliermondi
C. Albicans yaitu organisme komensal yang berada dirongga mulut. Organismenya adalah ragi
uniseluler dari Family Cryprococcaceae. Bentuknya vegetative, blastosphore, ukurannya 1,5-5 mm, bentuk
seluller memanjang (pseudohyphae) dan klamidospora yang terdiri dari badan sel ukuran 7-17 mm.
Etiologi
It is usually caused by
- Candida albicans,and lessfrequentlybyother fungal species
(C.glabrata,C.krusei,C.tropicalis,C.parapsilosis).
- Predisposing factors arelocal(poor oral hygiene, xerostomia, mucosaldamage, dentures,
antibiotic mouthwashes) andsystemic(broad-spec-trum antibiotics, steroids,
immunosuppressive drugs, radiation, HIV in-fection, hematological malignancies, neutropenia,
iron-deficiency ane-mia, cellular immunodeficiency, endocrine disorders).
Clinical feature

Bentuk candidiasis yang paling umum adalah pseudomembran akut/ sariawan.

Lesi oral kandidiasis akut (sariawan) bercirikan putih, kadang-kadang plak lunak tumbuh secara
sentrifugal dan bergabung
Plak terdiri dari fungal organism, keratotic debris, inflammatory cells, desquamated epithelial
cell, bacteric fibrin.
Sariawan dapat berkembang dimanapun, tapi yang paling sering ada di mukosa buccal, lipatan
mukobukus, orofaring, dan lateral aspek lidah.
Biasanya pasien mengeluhkan tenderness, burning dan dysphagia.
Clinical features
Oral candidiasis is classified as primary,consistingoflesionsexclusivelyon the oraland perioral
area, andsecondary, consist-ing of oral lesions of mucocutaneous disease. Primary candidiasis in-
cludes five clinical varieties: pseudomembranous, erythematous, nodu-lar, papillary hyperplasia
of the palate, and Candida-associated lesions(angular cheilitis, median rhomboid glossitis,
denture stomatitis). The main forms of candidiasis that produce white lesions are the following
Nodular candidiasis is a chronic form of the disease;it appears clinically as a white,firm,andraised
plaque that usually does not detach
(Fig.20)
Mucocutaneous candidiasis is a heterogeneous and rare group of clinical syndromes,
characterized by chronic lesions of the skin, nails, and mu-cosae,and usually associated with
immunological defects. Clinically,the oral lesions appear as white and usually multiple
plaques,which cannot be removed (Fig.21).
Laboratory tests
Laboratory tests Cytology and tissue culture examination;biopsy only in chronic cases
Differential diagnosis
Leukoplakia, hairy leukoplakia, lichen planus,syphiliticmucous patches,white sponge nevus,
chemicaland traumaticlesions, cinnamon contact stomatitis, lupus erythematosus
Treatment

Treatment
Topical antifungal agents (nystatin, azole derivatives, am-photericin B). Systemic azoles
(ketoconazole, fluconazole, itraconazole).
Prognosis
Prognosis pada penderita kandidiasis oral baik, tentunya dengan terapi yang tepat dan efektif.