Patient will present as → a 3-week-old infant with decreased appetite and a rash in her mouth. On physical exam, you note white plaques on her tongue that scrape off with a tongue depressor and bleed slightly. Potassium hydroxide (KOH) preparation of the scrapings demonstrates budding yeasts with hyphae.
Alternative presentation → a 33-year-old HIV-positive female presents with her second episode of oral thrush in the past 2 months. Her current CD4 count is 75.
Candidiasis (moniliasis) is skin infection with Candida species, most commonly Candida albicans
- Erythematous base, bleeds when scraped and scrapes off (unlike oral leukoplakia)
- If patient has recurrent candidiasis look for underlying disorder: immunocompromised, long term inhaled steroid use.
Scrapes off with a tongue depressor, may bleed
- Potassium Hydroxide (KOH) prep for diagnosis: budding yeast/hyphae
- Wet prep or biopsy can be done
Treatment is with antifungals, which are available in several forms (i.e., ketoconazole or fluconazole orally, clotrimazole troches, nystatin liquid rinses)
Question 1 |
leukoplakia Hint: Leukoplakia is a precursor lesion to oral cancer, seen most commonly in oral tobacco users. | |
hand–foot–mouth disease Hint: Herpangina and hand–foot–mouth disease are ulcerating lesions of the oral cavity due to viruses and are self-limiting, but can be very painful. | |
herpangina Hint: Herpangina and hand–foot–mouth disease are ulcerating lesions of the oral cavity due to viruses and are self-limiting, but can be very painful. | |
oral candidiasis |
