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Other Information

HIV-Associated Oral Candidiasis

Basics

  • Candidiasis (“thrush”) is also seen in immunocompromised patients and in neonates.

  • Curdlike or erosive lesions can easily be removed with gauze or a tongue blade (Fig. 33.18).

  • Lesions are more common on the dorsal aspect of the tongue, oropharynx, angles of mouth, and buccal mucosa.

  • The potassium hydroxide preparation shows yeast.

Management-icon.jpg Management

  • In patients with severe immunosuppression, intermittent or prolonged topical or oral antifungal treatment is usually necessary.

  • Meticulous dental hygiene and an oral rinse containing 0.12% chlorhexidine gluconate may be effective.

  • Oral therapy with fluconazole (Diflucan) produces remission within approximately 1 week. Fluconazole 100 mg qd is more effective than nystatin 500,000 U qid or clotrimazole troche 10 mg 5 times per day.

  • Maintenance therapy or intermittent therapy with fluconazole is essential to prevent relapse.