Oral Candidiasis: Manifestations, Treatment and Management in Immunocompromised Patients

Abstract

 Oral candidiasis is a common condition in immunocompromised patients, such as those with HIV and diabetes. It manifests in acute forms, for example, pseudomembranous candidiasis and erythematous candidiasis, as well as in chronic forms, including chronic hyperplastic candidiasis and prosthesis-induced candidiasis. The aim of this article is to provide an overview of oral candidiasis manifestations and treatment, and to highlight the importance of appropriate management of the disease in immunocompromised patients. The authors conducted a literature review on oral candidiasis to summarize clinical information and treatment indications. Median rhomboid glossitis, once considered a congenital malformation, is now recognized as a form of chronic candidiasis. Angular cheilitis is often caused by mixed infections with Candida and Staphylococcus aureus, particularly in the elderly population. Antifungal agents used in treatment include polyenes (nystatin and amphotericin B) and azoles (fluconazole and itraconazole), which act by inhibiting ergosterol biosynthesis in fungi. Antiretroviral therapy showed beneficial effects in reducing oral candidiasis in HIV-positive patients. In patients undergoing radiation therapy for oral carcinoma, the risk of candidiasis is increased, requiring preventive measures, such as proper oral hygiene and local antifungal therapies. Early diagnosis and targeted treatment are essential for managing oral candidiasis, especially in at-risk patients. A personalized therapeutic approach is crucial for reducing complications and preventing the malignant progression of such an unpleasant infection.