Clinical Appearance of Oral Candida Infection and Therapeutic Strategies.
Clinical Appearance of Oral Candida Infection and Therapeutic Strategies.
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DOI：
10.3389/fmicb.2015.01391
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发表时间：
2015
影响因子：
5.2
通讯作者：
Anil S
中科院分区：
文献类型：
--
作者：
Patil S;Rao RS;Majumdar B;Anil S
念珠菌是口腔的共生体和机会致病菌。几十年来，临床医生一直在研究其致病性，并根据最新的分子研究即兴制定新的治疗方案。念珠菌很容易从口腔中分离出来，但单纯的携带并不会导致感染的发展。它是作为共生体存在，还是转化为病原体，通常取决于宿主免疫系统中预先存在的或相关的变异。念珠菌感染的范围可以从无生命威胁的浅表粘膜皮肤疾病到涉及多器官的侵袭性播散性疾病。事实上，随着艾滋病病例数量的增加，不常见的口腔念珠菌感染又死灰复燃。确诊后的治疗应包括识别和消除潜在原因，如口腔用具不合适、药物史（抗生素、皮质类固醇等）、免疫和内分泌紊乱、营养缺乏状态和长期住院。用适当的局部抗真菌药物治疗，如两性霉素、制霉菌素或咪康唑，通常可以解决浅表感染的症状。偶尔，免疫功能低下患者可能需要全身性抗真菌药物，其选择应基于近期的唑暴露史、抗真菌药物不耐受史、主要念珠菌种类和当前的敏感性数据。
Candida species present both as commensals and opportunistic pathogens of the oral cavity. For decades, it has enthralled the clinicians to investigate its pathogenicity and to improvise newer therapeutic regimens based on the updated molecular research. Candida is readily isolated from the oral cavity, but simple carriage does not predictably result in development of an infection. Whether it remains as a commensal, or transmutes into a pathogen, is usually determined by pre-existing or associated variations in the host immune system. The candida infections may range from non-life threatening superficial mucocutaneous disorders to invasive disseminated disease involving multiple organs. In fact, with the increase in number of AIDS cases, there is a resurgence of less common forms of oral candida infections. The treatment after confirmation of the diagnosis should include recognizing and eliminating the underlying causes such as ill-fitting oral appliances, history of medications (antibiotics, corticosteroids, etc.), immunological and endocrine disorders, nutritional deficiency states and prolonged hospitalization. Treatment with appropriate topical antifungal agents such as amphotericin, nystatin, or miconazole usually resolves the symptoms of superficial infection. Occasionally, administration of systemic antifungal agents may be necessary in immunocompromised patients, the selection of which should be based upon history of recent azole exposure, a history of intolerance to an antifungal agent, the dominant Candida species and current susceptibility data.