Candida albicans

Candida leukoplakia still needs to be dealt with in a timely manner after it occurs. The cause of the disease must be found and the right medicine must be prescribed to make your condition improve faster. Generally, topical solutions are required for treatment to inhibit the growth of Candida albicans. Most of the lesions will disappear after one or two days of use, but prognosis work still needs to be done to prevent recurrence.

The most reliable laboratory method for candidiasis is currently the formation of thick-walled spores on corn culture medium, while the simplest method is specimen microscopic examination.

The dentistry department often takes specimens of pseudomembranes, desquamated epithelium, scabs, etc. of the oral mucosa, places them on a slide, adds a few drops of 10% potassium hydroxide solution, covers with a cover slip, heats over a low flame to dissolve the keratin, and then immediately performs a microscopic examination. If pseudohyphae or spores are found, it can be confirmed as a fungal infection, but it must be cultured to be confirmed as Candida albicans.

Acute pseudomembranous Candidal stomatitis should be differentiated from acute coccal stomatitis (membranous stomatitis). Membranous stomatitis is caused by infection with cocci such as Staphylococcus aureus, hemolytic Streptococcus, and Pneumococcus. It is more common in the elderly and can occur in the oral mucosa. The affected area is congested and edematous, and fibrinogen seeps from the blood vessels and coagulates into a grayish white or grayish yellow pseudomembrane with a smooth and dense surface that is slightly higher than the mucosal surface. The pseudomembrane can be easily wiped off, leaving behind an eroded surface with bleeding. Regional lymphadenopathy may be accompanied by systemic reactions. Smear or bacterial culture can identify the pathogen.

(1) 2% to 4% sodium bicarbonate (baking soda) solution: This medicine is commonly used to treat thrush in infants and young children. It is used to wash the mouth before and after breastfeeding to remove residual curd or sugar that can decompose and produce acid, making the mouth alkaline environment and preventing the growth and reproduction of Candida albicans. Children with mild symptoms do not need any other treatment, and the lesions will disappear within 2 to 3 days, but they still need to take medication for several days for prevention. This medicine can also be used to clean the nipples before and after breastfeeding to avoid cross-infection or repeated infection.

(2) Gentian violet aqueous solution: Gentian violet solution can still inhibit the growth of Candida albicans at a concentration of 1:100,000. A concentration of 1/2000 (0.05%) is appropriate for oral mucosa, applied three times a day to treat thrush and angular cheilitis in infants and young children. However, after staining, it is not advisable to observe changes in damage. The commercially available 1% gentiana purpurogenol solution is not suitable for use on the oral mucosa of infants and young children due to its high irritation, but it can be used for skin lesions.

(3) Chlorhexidine: Chlorhexidine has antifungal properties. It can be applied topically in the form of 0.2% solution or 1% gel, rinsed or gargled. It can also be combined with nystatin to form an ointment or cream. An appropriate amount of trimethoprim-sulfamethoxazole can also be added to it. It is used to treat angular cheilitis, denture stomatitis, etc. (The cream can be applied to the base tissue surface and worn in the mouth). Alternating gargling with chlorhexidine solution and sodium bicarbonate solution can eliminate the synergistic pathogenic bacteria of Candida albicans - Gram-negative bacteria.