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1.
Mycopathologia ; 185(4): 607-611, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32737746

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China, in late 2109, and has rapidly spread around the world. Until May 25, 2020, there were 133,521 confirmed COVID-19 cases and 7359 deaths in Iran. The role of opportunistic fungal infections in the morbidity and mortality of COVID-19 patients remains less defined. Based on our multicenter experiences, we categorized the risks of opportunistic fungal infections in COVID-19 patients in Iran. The COVID-19 patients at high risk included those with acute respiratory distress syndrome, in intensive care units, receiving broad-spectrum antibiotics, immunosuppressants or corticosteroid, and supported by invasive or noninvasive ventilation. The patients were most likely to develop pulmonary aspergillosis, oral candidiasis, or pneumocystis pneumonia. Most diagnoses were probable as the accurate diagnosis of opportunistic fungal infections remains challenging in resource-poor settings. We summarize the clinical signs and laboratory tests needed to confirm candidiasis, aspergillosis, or pneumocystosis in our COVID-19 patients.


Assuntos
Infecções por Coronavirus/complicações , Micoses/complicações , Infecções Oportunistas/complicações , Pneumonia Viral/complicações , Candidíase Bucal/complicações , Candidíase Bucal/diagnóstico , Candidíase Bucal/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Micoses/diagnóstico , Micoses/epidemiologia , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/epidemiologia , Pandemias , Doenças Faríngeas/complicações , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/epidemiologia , Doenças Faríngeas/microbiologia , Pneumocystis carinii , Pneumonia por Pneumocystis/complicações , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/epidemiologia , Pneumonia por Pneumocystis/microbiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Aspergilose Pulmonar/complicações , Aspergilose Pulmonar/diagnóstico , Aspergilose Pulmonar/epidemiologia
2.
Oral Dis ; 26 Suppl 1: 133-136, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862546

RESUMO

OBJECTIVE: To review the existing research literature on the paradigm that the oral lesions could be an indicator of the disease severity with the objective of documenting the current status of research, highlighting its major findings. MATERIAL AND METHODS: Publications were identified through a careful search, of which a majority focused on oral lesions as an indicator for HIV progression. A PubMed journal search of 10 years OF period publication (2009-2019) for "oral lesion, oral manifestation, indicator, HIV and HIV-associated" was performed and analysed. Various research methods were included within the study criteria including clinical study, clinical trial, comparative study and randomised control trial. RESULTS: A total 33 studies were obtained and analysed, including cohort study, cross-sectional study, case-control study, clinical trial, retrospective observational analysis study, prospective observational study and randomised control trial. The most common oral lesions found in the studies were Kaposi sarcoma (KS), followed by oral candidiasis, periodontitis, necrotising ulcerative gingivitis (NUG), necrotising ulcerative periodontitis (NUP) and oral hairy leucoplakia (OHL). The early diagnosis and accurate treatment plan were very important to indicate the disease severity related to HIV infection. CONCLUSION: Oral lesions reported in 39% articles and could be an indicator of HIV disease severity due to its effects on decreased cluster-differentiated (CD4+) T-cell count and increased viral load.


Assuntos
Candidíase Bucal , Infecções por HIV , Doenças da Boca , Contagem de Linfócito CD4 , Candidíase Bucal/diagnóstico , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Humanos , Leucoplasia Pilosa/diagnóstico , Leucoplasia Pilosa/etiologia , Doenças da Boca/diagnóstico , Doenças da Boca/virologia , Estudos Prospectivos , Estudos Retrospectivos , Índice de Gravidade de Doença
3.
J Mycol Med ; 30(3): 101009, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32620497

RESUMO

Chronic renal disease patients under chronic dialysis (CRDD) have a multifactorial immunological deterioration with an increased risk of Candida infections. Incidence of Candida infections is increasing. Choice of suitable antifungal agents is limited due to the resistance of some species to several antifungals. Aim of the present study was to identify the distribution and antifungal susceptibility patterns of oral isolated Candida species from infected and colonized patients, as well as to investigate the risk factors for oral infection in patients on dialysis. Cross-sectional study, approved by the institutional bioethics committees was performed in CRDD patients. Demographic, clinic data, and oral mucosa samples were obtained. Infection diagnosis was established clinically and confirmed with exfoliative cytology, each sample was plated on CHROMagar Candida and incubated at 36°C for 2 days. Yeast species were identified by carbohydrate assimilation ID 32C AUX system and the apiweb database. For the antifungal susceptibility test, the M44 A-3 method (CLSI) using fluconazole (FCZ), miconazole (MCZ), nystatin (NYS), and voriconazole (VCZ). Study included 119 participants, the main cause of CRD was nephropathy due to DM2 (58%), and three-fourths of the patients were under hemodialysis. Candida prevalence was 56.3% of 67 colonized or infected patients, 88 isolates were obtained. Principal identified species were C. albicans (51.1%), C. glabrata (25%), and C. tropicalis (14.8%). C. glabrata showed a reduced response to FCZ in 50% of isolates and C. albicans had a reduced response in 16% of the isolates. Antifungal agent with the least efficacious response or with the lowest susceptibility in the isolates of these patients was MCZ, followed by VCZ and FCZ, whereas NYS induced the best antifungal response.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candida/isolamento & purificação , Candidíase Bucal/microbiologia , Boca/microbiologia , Insuficiência Renal Crônica/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Candida/classificação , Candidíase Bucal/complicações , Candidíase Bucal/diagnóstico , Candidíase Bucal/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/terapia , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/microbiologia , Nefropatias Diabéticas/terapia , Farmacorresistência Fúngica/efeitos dos fármacos , Feminino , Humanos , Masculino , México/epidemiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Diálise Renal/efeitos adversos , Diálise Renal/estatística & dados numéricos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/terapia , Adulto Jovem
4.
Rev. cuba. estomatol ; 57(1): e1965, ene.-mar. 2020. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1126482

RESUMO

RESUMEN Introducción: Algunos tipos de cáncer suelen ser tratados con fármacos quimioterapéuticos que afectan de forma indirecta la cavidad bucal, los cuales susceptibilizan al paciente a contraer infecciones bucales como candidiasis bucal. Se ha evidenciado que una condición oncológica facilita una infección bucal por Candida albicans, sin embargo, otras especies de Candida se les relaciona poco. Objetivo: Identificar especies de Candida spp. en cavidad bucal de pacientes sometidos a quimioterapia. Métodos: Estudio descriptivo de corte transversal. Se tomaron 60 muestras de igual número de pacientes por conveniencia de un Instituto Oncológico en Barranquilla, Colombia. Previo a un examen clínico de diagnóstico de candidiasis bucal. Se tomaron hisopados en las superficies infectadas para realizar un examen directo -tinción de Gram y cultivo en agar dextrosa Sabouraud con cloranfenicol incubadas a 37 ºC durante 48 h y posteriormente cultivadas en medio CHROMagar® Candida- para identificación de diferentes especies. Se aplicó estadística descriptiva y de correlación. Resultados. El 55 por ciento de los pacientes correspondió al sexo femenino, con edades mayores a 60 años. El cáncer de mama fue el más frecuente en el 30 por ciento. La quimioterapia aplicada a todos fue el 5-fluorouracilo combinado con ciclofosfamida. El tipo clínico de candidiasis atrófica en lengua fue más frecuente en el 37 por ciento, seguida de candidiasis pseudomembranosa en lengua en el 33 por ciento. El 90 por ciento de muestras presentó algún tipo de Candida, crecimiento de una única especie y cultivos mixtos con más de una especie de Candida. Se evidenció el 13,3 por ciento de C. albicans y otro 13,3 por ciento de Candida spp. no albicans. Ninguno de los diagnósticos oncológicos tuvo una asociación estadísticamente significativa con las especies de Candida. Conclusiones: Se evidencia que la especie de C. albicans en candidiasis bucal en pacientes con cáncer, fue la más frecuente, con predominio en mayor proporción cultivos mixtos de Candida no albicans (C. glabrata, C. tropicalis) poco relacionados con este tipo de enfermedad(AU)


ABSTRACT Introduction: Some types of cancer are often treated with chemotherapeutic drugs which indirectly affect the oral cavity, thus making the patient vulnerable to infections such as oral candidiasis. Oral infection by Candida albicans has been found to be fostered by oncological conditions, but other Candida species have not been sufficiently analyzed in such a context. Objective: Identify Candida spp. in the oral cavity of patients undergoing cancer chemotherapy. Methods: A descriptive cross-sectional study was conducted of 60 samples of an equal number of patients selected by convenience sampling at an Oncological Institute in Barranquilla, Colombia, following diagnostic clinical examination for oral candidiasis. Swab samples were taken from the infected surfaces to perform direct examination - Gram staining and Sabouraud dextrose agar culture with chloramphenicol incubated at 37ºC for 48 h and then cultured in CHROMagar® Candida medium - for identification of various species. Analysis was based on correlation and descriptive statistics. Results: Of the total patients evaluated 55 percent were female and aged over 60 years. Breast cancer prevailed with 30%. The chemotherapy applied in all cases was 5-fluorouracil combined with cyclophosphamide. Atrophic candidiasis of the tongue was the most common clinical type with 37 percent, followed by pseudomembranous candidiasis of the tongue with 33 percent. Of the samples examined, 90 percent contained some sort of Candida, growth of a single species and mixed cultures with more than one Candida species. C. albicans represented 13.3 percent and non-albicans spp. another 13.3 percent. None of the oncological diagnostic analyses had a statistically significant association to Candida species. Conclusions: The species C. albicans was the most commonly found in oral candidiasis among cancer patients, with a predominance of non-albicans Candida spp. (C. glabrata, C. tropicalis) mixed cultures, a fact not generally related to this condition(AU)


Assuntos
Humanos , Candida albicans , Candidíase Bucal/diagnóstico , Neoplasias/tratamento farmacológico , Epidemiologia Descritiva , Estudos Transversais , Estudos Observacionais como Assunto
5.
Oral Dis ; 26(5): 941-947, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32011074

RESUMO

OBJECTIVE: A diagnostic test was designed to evaluate the accuracy and applicability of fluorescence staining with fluorescein-labelled chitinase versus routine 10% potassium hydroxide (KOH) smear for rapid diagnosis of oral candidiasis. METHODS: In total, 124 subjects with suspected oral candidiasis symptoms/signs were sequentially enrolled in this study. The diagnostic efficacy indexes (sensitivity, specificity, Youden index, predictive value, likelihood ratio, diagnostic odds ratio, diagnostic accuracy and area under the curve [AUC]) were compared between 10% KOH smear and fluorescence staining. RESULTS: The sensitivity (85.48% vs. 64.52%) and specificity (91.94% vs. 72.58%) of fluorescence staining were higher than those of KOH smear. The AUC of fluorescence staining (0.887) was remarkably higher than that of 10% KOH smear (0.685), demonstrating that the diagnostic efficacy of fluorescence staining is significantly higher than that of KOH smear (p = .0005). Furthermore, fluorescence staining showed higher sensitivity than that of KOH smear (84.75% vs. 62.71%) in diagnosis of erythematous type oral candidiasis, which is the most common type and the type most challenging to differentially diagnose. CONCLUSION: The advantages of fluorescence staining with fluorescein-labelled chitinase in rapid diagnosis of oral candidiasis and its ease of operation suggest its potential use in clinical practice.


Assuntos
Candidíase Bucal , Candidíase Bucal/diagnóstico , Testes Diagnósticos de Rotina , Fluorescência , Humanos , Hidróxidos , Compostos de Potássio , Sensibilidade e Especificidade , Coloração e Rotulagem
6.
Shanghai Kou Qiang Yi Xue ; 29(6): 567-572, 2020 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-33778820

RESUMO

PURPOSE: To investigate the diagnostic accuracy of matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) in the identification of clinical oral Candida isolates. METHODS: In the first experiment, 170 suspected oral candidiasis patients were included. Unstimulated saliva was collected and cultured on solid plate (Sabouraud's agar) for 48 hours. Clinical isolates were analyzed by both PCR, which was used as golden standard, and MALDI-TOF MS. The diagnostic accuracy of MALDI-TOF MS for both C.albicans and non-C.albicans were investigated. In the second experiment, we tried to identify Candida isolates directly from positive liquid culture in a new cohort of 42 patients. MALDI-TOF MS identification of candida isolates were performed on positive liquid medium cultures directly. The data were analyzed using SPSS 18.0 software package. RESULTS: Totally, 230 clinical Candida isolates were isolated from 212 oral candidiasis patients enrolled. Out of the 230 analyzed clinical isolates, C. albicans (65.65%, 151/230) was the most frequently isolated species, followed by C. glabrata (11.74%, 27/230), and other candida species. The sensitivity and specificity of MALDI-TOF in identification of C. albicans were 93.33% and 92.73% respectively, and those for non-C. albicans were 83.64% and 89.2% respectively. Oral rinse followed by culturing in Sabouraud's liquid medium for 24 hours yield the diagnostic accuracy of 78.42% in MALDI-TOF MS identification. CONCLUSIONS: C. albicans is the most frequent Candida spp. in oral candidiasis. MALDI-TOF MS is an effective and rapid method for identification of Candida spp. The on-plate based method generate much higher diagnostic accuracy than liquid culture based one.


Assuntos
Candidíase Bucal , Candida , Candida albicans , Candidíase Bucal/diagnóstico , Humanos , Sensibilidade e Especificidade , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz
7.
Clin Exp Dent Res ; 5(5): 580-582, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31687193

RESUMO

Objectives: Neonatal thrush, also called oral candidiasis, is commonly a clinical diagnosis based on white patches on oral mucosal surfaces. Candida albicans is often associated with it. This clinical study aimed to investigate the presence of C. albicans among newborns with or without clinical findings of candidiasis on oral mucosa. Another aim was to investigate how thrush responded to current therapy by acidic liquids such as lingonberry or lemon juice. Material and methods: Swipe samples were collected from 32 healthy, full-term infants younger than 12 months with or without white patches on oral mucosa. Clinical diagnosis of thrush was made by a community nurse based on thick and yellowish white patches. The routine therapy was oral lingonberry or lemon juice or soda water. Disappearing of patches was controlled by a phone call about 2 weeks after the baseline. Both parents and nurses gave background factors by filling a questionnaire. Results: One (3%) infant without clinical signs was diagnosed with Candida parapsilosis, none with C. albicans. Thrush resembling candidiasis was diagnosed clinically in four (12.5%) children. Three out of four parents reported persisting findings after 2 weeks. Only the maternal mastitis and use of antibiotics were significantly associated with thrush (p = .001). C. albicans was not discovered from babies with clinical thrush. Conclusions: Aetiology of the white patches remained unclear. The current way of treating them with acidic liquids is not efficient. Additional studies are needed.


Assuntos
Antifúngicos/uso terapêutico , Candida albicans/efeitos dos fármacos , Candidíase Bucal/tratamento farmacológico , Citrus/química , Doenças do Recém-Nascido/tratamento farmacológico , Vaccinium vitis-Idaea/química , Bebidas , Candidíase Bucal/diagnóstico , Candidíase Bucal/microbiologia , Humanos , Lactente , Recém-Nascido , Doenças do Recém-Nascido/microbiologia
8.
Rev. clín. med. fam ; 12(3): 163-166, oct. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-186809

RESUMO

Presentamos un caso de leucoplasia verrucosa proliferativa, que es una lesión multifocal y progresiva que se presenta en forma de placas blancas en la cavidad oral, de etiología desconocida, resistente a todo intento de tratamiento y con alta recurrencia. Su conocimiento y seguimiento es de especial relevancia por la alta tasa de malignización a carcinoma de células escamosas y a carcinoma verrucoso. Es decir, se trata de una lesión premaligna agresiva, sin claro consenso sobre su etiología, y sin tratamiento efectivo en el momento actual, por lo que requiere de su conocimiento, diagnóstico precoz y seguimiento estricto


We present a case of proliferative verrucous leukoplakia, a multifocal progressive lesion that occurs as white patches in the oral cavity, of unknown etiology, treatment resistant, and with a high recurrence rate. Knowledge and follow-up of this disease is particularly relevant due to its high risk of progressing to malignant squamous cell carcinoma and to verrucous carcinoma. That is, it is an aggressive premalignant lesion, lacking an agreed etiology and an effective treatment at the present time. Therefore it requires knowledge of it, an early diagnosis and a close follow-up


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Língua/diagnóstico , Leucoplasia Oral/diagnóstico , Epidermodisplasia Verruciforme/diagnóstico , Lesões Pré-Cancerosas/diagnóstico , Detecção Precoce de Câncer/métodos , Candida albicans/isolamento & purificação , Candidíase Bucal/diagnóstico , Diagnóstico Diferencial , Tabagismo/complicações
9.
PLoS One ; 14(9): e0223072, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31557235

RESUMO

AIM: To investigate the correlation between the dorsal tongue porphyrin autofluorescence, revealed using VELscope, and Candida saprophytism. MATERIAL AND METHODS: Consecutive patients underwent an autofluorescence examination by the VELscope device to establish the presence or absence of porphyrin fluorescence. A tongue swab was collected for the Candida cultural test. Sensitivity, specificity, accuracy, negative predictive value and positive predictive value were calculated considering the oral swab as the gold standard. The degree of agreement between the two tests was calculated using Cohen's K coefficient. RESULTS: One hundred twenty-six patients were enrolled. Porphyrin fluorescence method showed a sensitivity of 78%, specificity of 76% and an accuracy of 78%. Negative predictive value and positive predictive value were respectively 90% and 59%. The strength of agreement between the two methods resulted to be moderate (k = 0.551). CONCLUSIONS: Off-label use of tongue autofluorescence examination to detect the presence of Candida species is characterized by a loss of porphyrin fluorescence. The high negative predictive value of porphyrin fluorescence loss suggests its use in preliminary selection of Candida carriers, in order to plan preventive and therapeutic strategies.


Assuntos
Candida/isolamento & purificação , Candidíase Bucal/diagnóstico , Imagem Molecular/métodos , Imagem Óptica/métodos , Porfirinas/química , Língua/diagnóstico por imagem , Adulto , Idoso , Biópsia , Candida/metabolismo , Candidíase Bucal/microbiologia , Feminino , Fluorescência , Humanos , Masculino , Pessoa de Meia-Idade , Porfirinas/metabolismo , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade , Língua/microbiologia
10.
Clin Interv Aging ; 14: 1297-1302, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31409979

RESUMO

Objectives: To answer to the following questions: is there any relationship between oral hygiene and the growth of yeast in patients without mucosal inflammation; and is there a need for mycological examination patients without mucosal inflammation? Background: Patients with candidiasis may report varied symptoms, but such infections are most often asymptomatic. In addition to its high incidence in denture users (60%-100%), there is a concern that Candida species from the oral cavity may colonize the upper gastrointestinal tract and lead to septicemia, which has a 40%-79% mortality rate and can require a prolonged hospital stay. It is thus important for all physicians to be aware of the risk factors, diagnosis, and treatment of oral candidiasis in older patients. Methods: A retrospective study was carried out on a group of patients who had undergone mycological examination and assessment of the intensity of yeast growth, and oral hygiene. Results: Ninety-one denture wearers who lacked signs of clinical inflammation were included in the study. The growth of Candida albicans was as follows: 14 patients had up to 20 colonies; 19 patients had over 20 colonies. Ten percent of patients with good oral hygiene proved to have more than 20 yeast colonies. 5% of patients with bad oral hygiene had more than 20 colonies. Conclusions: There was no relationship found between hygiene and the growth rate of fungal microorganisms. In patients without clinical symptoms of stomatitis, mycological examination should be considered.


Assuntos
Candidíase Bucal/epidemiologia , Dentaduras/microbiologia , Higiene Bucal/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Candidíase Bucal/diagnóstico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
11.
Rev. Rol enferm ; 42(7/8): 488-495, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187129

RESUMO

El presente artículo describe un caso clínico de un paciente atendido en la consulta de atención primaria por presentar afrontamiento defensivo frente a su enfermedad, causado por una infección de VIH+ en estadio de SIDA. Se realiza seguimiento del usuario en la consulta de enfermera de familia, se desarrolla el plan de cuidados siguiendo el modelo AREA (Análisis del Resultado del Estado Actual) para la priorización de diagnósticos, teniendo en cuenta las preferencias del propio usuario. Se siguen las directrices CARE para la elaboración del caso


The present article describes a clinical case of a patient taken care of in the primary care consultation who pre-sent defensive facing against his disease, caused by an infection of VIH+ in stage of SIDA. The user is followed up in the Family Nursing consultation, the care plan is developed following the AREA model for the prioritization of diagnoses, taking into account the preferences of the user. The CARE guidelines are followed for the preparation of the case


Assuntos
Humanos , Masculino , Adulto , Síndrome de Imunodeficiência Adquirida/enfermagem , Enfermagem Familiar , Autoimagem , Síndrome de Imunodeficiência Adquirida/diagnóstico , Candidíase Bucal/diagnóstico , Atitude Frente a Saúde , Síndrome de Imunodeficiência Adquirida/psicologia , Terminologia Padronizada em Enfermagem
12.
Oral Dis ; 25(7): 1798-1808, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31257663

RESUMO

OBJECTIVES: To evaluate (a) oral colonization of Candida species, especially for non-albicans Candida species (NACS), in xerostomic postradiotherapy head and neck cancer patients and (b) risk factors affecting their colonization. MATERIALS AND METHODS: Subjective and objective dry mouth scores, stimulated salivary flow rates, pH and buffering capacity were measured in 72 xerostomic postradiotherapy head and neck cancer patients. Candida counts and species identification were performed using oral rinse samples cultured in Candida Chromagar, followed by polymerase chain reaction and API 20C AUX system. RESULTS: Candida colonization was observed in 87.5% of subjects, with 80.6% and 48.6% of study population colonized by C. albicans and NACS, respectively. NACS was associated with high objective dry mouth scores, denture use, and females (p = .006, .009, and .036, respectively). In addition, Candida glabrata was detected more in females (p = .018) and denture wearers (p = .026), while Candida tropicalis was associated with high objective dry mouth scores (p = .022) and females (p = .027). Quantity of Candida colonization correlated positively with objective dry mouth scores (r = 0.599, p < .001) and negatively with salivary flow rates (r = -0.258, p = .041) and pH (r = -0.290, p = .022). CONCLUSION: NACS colonization was common in xerostomic head and neck cancer patients. Increased signs of dry mouth, female and dental prostheses may promote NACS colonization.


Assuntos
Candida/efeitos da radiação , Candidíase Bucal/epidemiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Boca/efeitos da radiação , Saliva/efeitos da radiação , Xerostomia/radioterapia , Adulto , Idoso , Candida/efeitos dos fármacos , Candida/crescimento & desenvolvimento , Candida albicans/efeitos dos fármacos , Candida albicans/crescimento & desenvolvimento , Candidíase Bucal/diagnóstico , Contagem de Colônia Microbiana , Feminino , Humanos , Pessoa de Meia-Idade , Boca/microbiologia , Saliva/metabolismo , Saliva/microbiologia , Glândulas Salivares/efeitos da radiação , Taxa Secretória/efeitos da radiação , Xerostomia/etiologia
13.
Ann Otol Rhinol Laryngol ; 128(10): 903-910, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31072118

RESUMO

OBJECTIVE: In laryngology practice, vocal fold leukoplakia is frequently evaluated by suspension laryngoscopy and biopsy examination upon the patient's complaints of hoarseness and dysphonia. The purpose of the present study is to investigate and analyze risk factors, diagnosis, treatment, and follow-up results of cases with Candida leukoplakia. STUDY DESIGN: Retrospective case control study. SETTING: Tertiary medical center. SUBJECTS AND METHODS: Patients with a diagnosis of vocal fold leukoplakia who underwent direct laryngoscopy and biopsy between 2007 and 2017 and diagnosed as candida or noncandida in their histopathology were assigned into 2 groups. Then they were compared in terms of their demographic characteristics, predisposing factors, diagnosis, treatment, and follow-up results. RESULTS: Of the 289 vocal fold leukoplakia cases, 36 were candida, and 253 were noncandida. The mean age of the patients with Candida leukoplakia was 60.86 years. As for the age groups, the largest group (26.1%) was in the seventh decade (P < .001). The use of inhaled corticosteroids was a significant risk factor (P < .001). For their medical therapy, the patients were administered fluconazole 200 mg per day for 3 weeks, and the treatment yielded successful results in 91.66% of them. In 5 of the patients, candida leukoplakia and superficial epithelial dysplasia were observed, and no malignant transformation was observed during a mean follow-up of 28 ± 13 months. CONCLUSION: Candidiasis causing vocal fold leukoplakia is rare, and we report the findings of the largest published case series to date. Eliminating predisposing factors and administrating oral fluconazole 200 mg for 3 weeks are sufficient for medical treatment.


Assuntos
Candidíase Bucal/diagnóstico , Candidíase Bucal/patologia , Doenças da Laringe/microbiologia , Doenças da Laringe/patologia , Leucoplasia/microbiologia , Prega Vocal/microbiologia , Prega Vocal/patologia , Administração por Inalação , Corticosteroides/efeitos adversos , Idoso , Antifúngicos/uso terapêutico , Biópsia , Candidíase Bucal/tratamento farmacológico , Estudos de Casos e Controles , Disfonia/etiologia , Feminino , Fluconazol/uso terapêutico , Seguimentos , Rouquidão/etiologia , Humanos , Doenças da Laringe/tratamento farmacológico , Laringoscopia , Leucoplasia/complicações , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
14.
Acta Odontol Scand ; 77(7): 508-516, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31145647

RESUMO

Aims: Oral candidiasis is a major oral manifestation of uncontrolled diabetes mellitus, and a number of cofactors are associated with the pathogenesis of this infection. Here, we describe the prevalence of oral Candida in a Sri Lankan cohort of type 2 diabetes mellitus and risk factors that predispose them to this common fungal infection. Methods: A case-control study was conducted in 250 diabetics with type 2 diabetes and 81 nondiabetic controls. Clinical and demographic data were collected using an interviewer administered questionnaire, and patient records. Oral rinse samples were collected to determine the candidal carriage, and the resultant yeast growth was quantified and speciated using multiplex-PCR and phenotypic analyses. Chi-square test (χ2 test) and Fisher exact test were used for the determination of the significant relationships between risk factors and oral candidiasis. Results: The oral prevalence of Candida species among both groups was similar (81%) although a significantly higher proportion of diabetics (32.8%) yielded >2000 CFU/mL of yeasts compared with only 12.3% of the healthy controls (p < .05). Significant associations were noted between oral candidal carriage amongst diabetics, and (i) denture wearing, (ii) female gender and (iii) cigarette smoking (all, p < .05). Amongst both groups, C.albicans was the most common Candida species isolated followed by C. parapsilosis, C. tropicalis and C. glabrata. Conclusions: The oral infestation of Candida in our Sri Lankan cohort of diabetics is significantly higher than their healthy counterparts, and co-carriage of multiple yeast species is a common finding in the study population. As there are no previous such reports of the latter phenomenon particularly from the Asian region it is noteworthy, mainly in view of the recent data on the emergence of drug-resistant yeast species the world over.


Assuntos
Candida/isolamento & purificação , Candidíase Bucal/diagnóstico , Complicações do Diabetes , Diabetes Mellitus Tipo 2/diagnóstico , Adulto , Candida/classificação , Candida albicans/isolamento & purificação , Candidíase Bucal/epidemiologia , Candidíase Bucal/microbiologia , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/microbiologia , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Distribuição por Sexo , Sri Lanka/epidemiologia
15.
Swiss Dent J ; 129(5): 403-405, 2019 May 13.
Artigo em Alemão | MEDLINE | ID: mdl-31091860

RESUMO

Aim of this paper is to give an overview about topical and systemic therapy options for the oral candidiasis. The clinical presentation of oral candidiasis is mostly white, easily wiped off coatings or erythematous efflorescences, with several subtypes. Antifungal therapy is indicated in case of clinical symptoms or as prevention for immune-compromised patients. In addition, local or systemic factors should be revealed and improved. An appropriate oral hygiene is essential for the treatment and prevention of possible reinfection.


Assuntos
Antifúngicos , Candidíase Bucal , Antifúngicos/uso terapêutico , Candidíase Bucal/complicações , Candidíase Bucal/diagnóstico , Candidíase Bucal/tratamento farmacológico , Humanos
16.
BMC Microbiol ; 19(1): 96, 2019 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088370

RESUMO

BACKGROUND: Several conventional methods, including fungal culture and periodic acid-Schiff (PAS) reagent staining, have been used to diagnose oral candidiasis. The aim of this study was to evaluate the efficacy of a novel method, fungal fluorescent staining, in relation to conventional protocols in the diagnosis of oral candidiasis. METHODS: We collected 106 oral swabs and 122 oral biopsy tissues from patients highly suspected with oral candidiasis. We applied fungal culture and periodic acid-Schiff reagent staining as the gold standard diagnostic tools. The efficacy of these methods in determining the presence of Candida was compared with that of fluorescent staining. RESULTS: In the majority of specimens subjected to fluorescent staining, fungal organisms were distinguished by blue fluorescence surrounding their tubular or annular shapes. The sensitivity, specificity, Youden index, positive predictive value and negative predictive value of the fluorescent staining method were 82.7, 93.5, 76.7, 96.8 and 69.1% in oral swabs and 90.0, 92.9, 82.9, 96.0 and 82.9% in oral biopsy tissues, respectively. CONCLUSIONS: Fungal fluorescent staining represents a rapid method for detection of Candida, supporting its potential utility as an effective early diagnostic tool for oral candidiasis.


Assuntos
Candidíase Bucal/diagnóstico , Fluorescência , Microscopia de Fluorescência , Coloração e Rotulagem , Adulto , Idoso , Biópsia , Candidíase Bucal/microbiologia , Feminino , Corantes Fluorescentes , Humanos , Masculino , Pessoa de Meia-Idade , Boca/microbiologia , Boca/patologia , Reação do Ácido Periódico de Schiff , Valor Preditivo dos Testes , Sensibilidade e Especificidade
17.
Head Neck Pathol ; 13(1): 25-32, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30693459

RESUMO

Candidiasis is a very common malady in the head neck region. This review will concentrate on intraoral, pharyngeal and perioral manifestations and treatment. A history of the origins associated with candidiasis will be introduced. In addition, oral conditions associated with candidiasis will be mentioned and considered. The various forms of oral and maxillofacial candidiasis will be reviewed to include pseudomembranous, acute, chronic, median rhomboid glossitis, perioral dermatitis, and angular cheilitis. At the end of this review the clinician will be better able to diagnose and especially treat candidal overgrowth of the oral facial region. Of particular interest to the clinician are the various treatment modalities with appropriate considerations for side effects.


Assuntos
Candidíase Bucal/diagnóstico , Candidíase Bucal/patologia , Humanos
18.
Emerg Med Clin North Am ; 37(1): 55-68, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30454780

RESUMO

Soft tissue disorders of the mouth encompass a wide expanse of pathophysiology. This article focuses on the identification, etiology, management, and complications of common infectious processes (candidiasis, dental caries, and herpes labialis), inflammatory lesions (sialolithiasis, oral lichen planus, and aphthous ulcer), and benign entities (bony tori and mucocele).


Assuntos
Doenças da Boca/diagnóstico , Candidíase Bucal/diagnóstico , Candidíase Bucal/tratamento farmacológico , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Emergências , Herpes Labial/diagnóstico , Herpes Labial/tratamento farmacológico , Humanos , Leucoplasia Oral/diagnóstico , Leucoplasia Oral/terapia , Líquen Plano Bucal/diagnóstico , Líquen Plano Bucal/terapia , Doenças da Boca/terapia , Mucocele/diagnóstico , Mucocele/terapia , Cálculos das Glândulas Salivares/diagnóstico , Cálculos das Glândulas Salivares/terapia , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/terapia
19.
Colomb Med (Cali) ; 49(3): 193-200, 2018 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-30410193

RESUMO

Background: The yeasts species determination is fundamental not only for an accurate diagnosis but also for establishing a suitable patient treatment. We performed a concordance study of five methodologies for the species identification of oral isolates of Candida in Colombia. Methods: Sixty-seven Candida isolates were tested by; API® 20C-AUX, Vitek®2 Compact, Vitek®MS, Microflex® and a molecular test (panfungal PCR and sequencing). The commercial cost and processing time of the samples was done by graphical analysis. Results: Panfungal PCR differentiated 12 species of Candida, Vitek®MS and Microflex® methods identified 9 species, and API® 20C-AUX and Vitek®2 Compact methods identified 8 species each. Weighted Kappa (wK) showed a high agreement between Panfungal PCR, Vitek®MS, Microflex® and API® 20C-AUX (wK 0.62-0.93). The wK that involved the Vitek®2 Compact method presented moderate or good concordances compared with the other methods (wK 0.56-0.73). Methodologies based on MALDI TOF MS required 4 minutes to generate results and the Microflex® method had the lowest selling price. Conclusion: The methods evaluated showed high concordance in their results, being higher for the molecular methods and the methodologies based on MALDI TOF. The latter are faster and cheaper, presenting as promising alternatives for the routine identification of yeast species of the genus Candida.


Assuntos
Candida/isolamento & purificação , Candidíase Bucal/diagnóstico , Reação em Cadeia da Polimerase/métodos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Adulto , Candidíase Bucal/microbiologia , Colômbia , Humanos , Técnicas de Tipagem Micológica/métodos , Fatores de Tempo
20.
Tunis Med ; 96(2): 142-147, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30324980

RESUMO

INTRODUCTION: Acute esophageal necrosis, also known as black esophagus, is a rare digestive complication, frequently manifested by an upper gastrointestinal hemorrhage and occurs in patients with comorbidities. AIM: To report the case of a patient with a black esophagus revealed by an upper gastrointestinal hemorrhage. OBSERVATION: A 72-year-old patient with a history of diabetes mellitus, hypertension and ischemic heart disease was hospitalized in surgical intensive care unit for hemorrhagic shock induced by cholecystectomy. On the 7th postoperative day, the patient developed acute hematemesis. Gastroscopy showed circumferential necrosis, localized in the middle and lower third of the esophagus and stopped abruptly at the gastroesophageal junction. Gastric mucosa was strictly normal. The bulb and the first part of duodenum showed multiple superficial ulcers without signs of recent hemorrhage. The patient was placed on absolute diet and total parenteral nutrition associated with high-dose intravenous proton pump inhibitor. Second-look gastroscopy, performed six days later, showed a significant improvement in esophageal lesions. The evolution was marked by the occurrence of pneumonia complicated by septic shock which caused patient's death. CONCLUSION: Black esophagus is a rare pathology of multifactorial etiology. Treatment is based on proton pump inhibitors in combination with resuscitation measures to control comorbidities. Mortality remains high due to the seriousness of comorbid disease states often associated with this condition.


Assuntos
Esofagite/diagnóstico , Esôfago/patologia , Idoso , Candidíase Bucal/complicações , Candidíase Bucal/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/microbiologia , Esofagite/microbiologia , Esôfago/microbiologia , Evolução Fatal , Feminino , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/microbiologia , Hematemese/diagnóstico , Hematemese/microbiologia , Humanos , Necrose/diagnóstico , Necrose/microbiologia , Pigmentação , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Choque Séptico/complicações , Choque Séptico/diagnóstico
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