An Unconventional Oral Candidiasis in an Immunocompetent Patient

Abstract

Oral candidiasis (OC) is an opportunistic fungal infection of the oral mucosae, sustained by Candida albicans or other non-albican Candida species (NAC), usually eradicated by conventional antifungals of the classes of azoles, polyenes, or derivative from echinocandins. OC usually occurs under predisposing local or systemic factors. C. lusitaniae is an opportunistic strain that is rarely responsible for human infection and occurs mainly in severe immunocompromised states. The present work reported an unconventional case of OC in an otherwise healthy immunocompetent woman sustained by C. lusitaniae and a multi-resistant strain of C. albicans.

Keywords: Candida spp.; antimycogram; biofilm; hyphae; oral candidiasis; yeast cell.

Figure 1

Oral Candidiasis clinical features. (A) Erythema and erosive areas at the palate. (B) Erythematous-atrophic glossitis.

Figure 2

Comparison between C. albicans from the first and the last swab. (A) Genomic fingerprinting of C. albicans from the first and the last swabs obtained by RAPD-PCR. (B–G) Gram staining of C. albicans from the last (B) and first swabs (C) at 40× magnification. (D,E) Gram staining of C. albicans from last swab at 100× magnification. (F,G) Gram staining of C. albicans from first swab at 100× magnification. Note the hyphal pattern in the first swab (C,F,G) and the yeast cells in the last swab (B,D,E).

Figure 3

OD readings at 570–655 nm of biofilm growth of C. albicans from first and last swabs after 24 and 48 h.

Figure 4

Clinical feaures of oral lesions after therapy. The brownish areas on the tongue are due to povidone-iodine pigmentation and persisted smoking.