%0 Journal Article
%T What Makes Oral Candidiasis Recurrent Infection? A Clinical View
%A Azmi M. G. Darwazeh
%A Tamer A. Darwazeh
%J Journal of Mycology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/758394
%X Clinical oral Candida infection (candidiasis) is one of the common oral mucosal infections, and its management is usually frustrating due to either treatment failure or recurrence. Historically, oral candidiasis has been branded as disease of diseased. The unsuccessful management of oral candidiasis can due to either incorrect diagnosis, failure to identify (or correct) the underlying predisposing factor(s), or inaccurate prescription of antifungal agents. Failure to properly treat oral candidiasis will lead to persistence of the fungal cell in the oral cavity and hence recurrence of infection. The oral health care provider should be aware of these fall pits in order to successfully manage oral candidiasis. 1. Introduction Oral candidal colonization and candidiasis have recently received increased attention by the health care providers and researchers alike, particularly following the emergence of human immunodeficiency virus (HIV) infection and the widespread use of broad spectrum antibiotics and immunosuppressant therapy [1]. The genus Candida comprised more than 150 species which are widely spreading in the environment. Knowing that the majority of the species cannot live at the human body temperature [2] explains why the oral cavity is colonized with only a limited number of Candida species. Candida species constitute part of the oral harmless commensal flora in about 2¨C70% of the general population but is responsible for causing infection if the host immune barriers are breached either on the local or on the systemic level [1]. Candida albicans is the species largely responsible for oral candidiasis which is the most common human fungal infection especially in childhood and the elderly. It is not uncommon to encounter a recurrence of the oral candidal infection after some time of institution of antifungal therapy, which constitutes a frustration and disappointment for both the clinician and the patient. One study estimated that around 20% of patients with oral candidiasis experience infection recurrence and in around 30% of the recurrences the second isolate was different from that responsible for the first episode of infection [3]. This raises the question whether the ˇ°recurrenceˇ± is a second infection or due to ˇ°persistentˇ± Candida cells. If the superficial oral candidal infection was not well managed in severe immunosuppression, the patient may become susceptible to esophageal spread of infection or to the potentially lethal systemic candidemia [4]. Therefore, it is essential for the oral candidal infection to be diagnosed accurately and managed
%U http://www.hindawi.com/journals/jmy/2014/758394/