Help! Please Register



  The Fungi

  Image Bank
  Lecture Bank
  Video Bank




  MIC Database

  Education &

  Good Books

  About Us

  Our Mission
  Editorial Board
  Editorial Staff
  Legal Stuff
  Privacy Policy

This page updated:
1/27/2007 9:23:00 AM

DoctorFungus - All Rights Reserved © 2007 Copyright
& Privacy Policy

Site built and designed for doctorfungus by Webillustrated

You are here: Mycoses >
Navigate this section from here:

Oropharyngeal Candidiasis


Oropharyngeal candidiasis (OPC) is the general term given to the oral infection caused by the yeast Candida. This condition is also often referred to informally as thrush. As we will discuss in detail in this section, OPC meets all the criteria to be considered an opportunistic infection. Whereas asymptomatic oral colonization may also occur, OPC implies the presence of signs and symptoms of infection.


Candida spp. are part of the normal mouth flora in 25-50% of healthy individuals [1672]. Such carriage is referred to as asymptomatic colonization. Candida albicans is the most frequent colonizer (70-80%) but any of the non-albicans Candida spp. may be seen. Salivary flow, salivary pH, and glucose concentration are among the factors that influence the frequency of oral candidal colonization. Specifically, carriage rates are higher in:
  • HIV-infected patients and patients with AIDS. In these patients, the rate of carriage is a function of the level of immunosuppression [2025]. Patients heavily treated with fluconazole more often carry non-albicans Candida spp. that are resistant to the azole antifungal agents [159, 1402, 1403, 1404, 1458].
  • Hospitalized patients regardless of underlying disease [318].
  • Denture users [336]
  • Diabetic patients [2224]
  • Cancer patients [268]
OPC, on the other hand, goes beyond mere carriage to the presence of symptomatic infection. This transformation from asymptomatic colonization to symptomatic disease occurs most often in people in the extreme of their lives (neonates and the elderly), in patients with debilitating conditions, and in individuals receiving certain types of drug therapy [1672]:

Factors that promote development of symptomatic OPC

Treatment-related (iatrogenic) Disease-Related General Conditions
Local treatments
Inhaled steroids
Oropharyngeal irradiation [733]
Trauma (dentures) [2388]

Systemic treatments
Broad-spectrum antibiotics
Cytotoxic cancer1 therapy
Immunosuppressive therapy

HIV-AIDS [722]
CMC2 [1197]
Malignancies [268, 2470]

Diabetes mellitus4
Adrenal dysfunction

Premature infants
Newborn healthy infants
Elderly individuals [1672]


  1. The incidence of OPC among cancer patients varies depending on the type of neoplastic disease. An incidence of OPC was initially reported as ~25% in patients with solid tumors and up to 60% in patients with hematologic malignancies and/or following bone marrow transplantation. Due to the widespread use of prophylactic antifungal therapy in these groups, however, current rates of OPC have decreased significantly [268, 2470]. Patients subjected to radiotherapy for the treatment of oral and pharyngeal malignancies are also frequently affected with OPC [733].
  2. Chronic mucocutaneous candidiasis
  3. The many endocrinopathies of chronic mucocutaneous candidiasis are all at least somewhat related to OPC.
  4. OPC most often appears in diabetics who have poorly controlled blood sugar levels [2300].

Clinical Manifestations

Although the most frequent and familiar form of OPC is pseudomembranous candidiasis (or thrush), there are two additional distinctive presentations of OPC [2012]. The general characteristics of the three main forms of OPC are shown in the table, with a more detailed discussion following:

Type Site(s) affected Appearance Symptoms
Pseudomembranous ("thrush") Buccal mucosa, tongue, palate, uvula White thick plaques that, when removed, leave an erythematous bleeding surface Varies according to the extent and severity but includes burning, pain, and taste changes
Erythematous or atrophic (includes denture-induced stomatitis) Palate, tongue Diffuse erythema Soreness
Angular cheilitis Angles of mouth Cracking and inflammation of the corner of the mouth Pain, soreness, and/or burning
  1.   Pseudomembranous Oropharyngeal Candidiasis

    This is the most frequently recognized presentation. It is commonly called thrush and presents with raised confluent white to creamy elevated patches on a hyperemic base. This can be better appreciated when plaques are removed and the base bleeds. The lesions can involve any part of the mouth.

    Patients affected with pseudomembranous OPC complain of mouth soreness or pain, burning tongue, taste changes, or dryness. Chronic oral discomfort associated with this form of candidiasis, especially in patients with AIDS, may impair the intake of adequate oral nutrition and contribute to weight loss and inanition. The presence of odynophagia (pain on swallowing) suggests extension of the process to the form known as Esophageal Candidiasis.

    Mild Pseudomembranous OPC
    Mild Pseudomembranous OPC
    Severe Pseudomembranous OPC
    Severe Pseudomembranous OPC

  2. Erythematous or Atrophic Oropharyngeal Candidiasis

    Erythematous candidiasis

    Erythematous or atrophic oropharyngeal candidiasis presents with diffuse redness of the palate and the dorsum of the tongue. When the infection is principally on the tongue, the term candidal glossitis is used.

    Chronic atrophic candidiasis is associated with an indolent course. Some patients have no symptoms, whereas others complain of a metallic taste or a local burning sensation. Denture wearers seem especially prone to this condition, in which case it is referred to as denture-induced stomatitis or denture sore mouth.

  3. Angular Cheilitis

    Angular cheilitis

    This form of OPC has also been called "perleche." It is characterized by inflammation of the angles of the mouth, with or without fissuring. Other causes of this picture include iron deficiency and Staphylococcus aureus infection. Patients are usually very symptomatic with local soreness, tenderness, pain or burning.

  4. Miscellaneous forms of OPC

    Other forms of OPC have also been described. Candidal leukoplakia has been reported as a condition in which Candida are cultured from leukoplakic lesions [1255, 2322]. However, as the species composition of the mycoflora of these leukoplakic lesions does not differ from the species cultured from normal mucosa [1672, 1929], it is unclear whether Candida are playing a role. Thus, we do not currently list this as a separate form of OPC. In addition, there is a single report of an entity described as candidal glossitis [470], but this does not appear to represent a distinctive major entity.

The many different therapeutic options available for treatment of oropharyngeal candidiasis are shown in the table. Topical therapy usually suffices for milder forms of the disease. However, extensive disease, disease in patients with immunosuppression (most notably, disease in HIV/AIDS patients), and disease in which there are symptoms that suggest esophageal involvement (e.g., pain on swallowing) are best treated with systemic therapy. Prolonged suppressive therapy may be required if the immunosuppressive condition does not remit.

Drug Dosage Comments References
Nystatin Pastilles or lozenges: 200,000U qid x 7-14 days

Suspension: 500,000 Units by swish & swallow qid x 7-14 days
It has an unpleasant taste and may cause nausea and GI disturbance. Vaginal tablets in combination with unsweetened mints or chewing gum are better tolerated [899]. [747, 1132, 1824]
Clotrimazole Suck on 1 troche 5x day x 7-14 days It is more palatable than nystatin but contains dextrose which may promote dental caries [899] [1567, 1824, 2091]
Fluconazole 100 mg/d x 7-14 days (a loading dose of 200mg has been recommended for immunosuppressed patients and/or severe OPC) Fluconazole is superior to nystatin, clotrimazole, and ketoconazole [543]. High doses (up to 800mg/day) can be used in difficult cases. Success has been obtained even in cases of in vitro resistance [1900]. [543, 747, 1035, 1223, 1824, 1825, 2025]
Itraconazole Suspension: 200 mg (20 ml) qd by swish & swallow without food x 7-14 days

Capsules: 200 mg/day (taken with food) x 2-4 weeks
The capsules have limited bioavailability and their absorption is improved if they are taken with a fatty meal. The efficacy of the capsules is thought about equal to that of ketoconazole [257]. The solution has only been tested among HIV patients, but is much better absorbed and has shown an efficacy equivalent to fluconazole [895, 1788]. [171, 539, 895]
Ketoconazole 200-400 mg/day x 7-14 days This agent has limited bioavailability, requires an acidic environment for best absorption, and causes liver toxicity. As it is less efficacious than fluconazole and itraconazole suspension, it is less frequently used. [539, 1283]

Difficult Clinical Situations

  1. Oropharyngeal Candidiasis (OPC) in patients with HIV-AIDS
    Early in the HIV epidemic, OPC was identified as not only an immunologic marker of HIV infection but also of rapid progression to AIDS [1214]. Oropharyngeal candidiasis occurs in about one third to one half of HIV-seropositive persons and in up to 90% of patients with AIDS, making it the most frequent opportunistic infection in AIDS [722, 2025].

    Symptomatic OPC is rare until the CD4+ T-cells fall to < 500 cells/mm3. As AIDS progresses, either because of lack of adequate therapy or resistance to antiretroviral therapy, the severity and permanent nature of AIDS-associated immunosuppression make this infection particularly difficult to permanently eradicate. The natural history in patients with advanced HIV infection is one of remission and then relapse.

    Prophylaxis (or, really, chronic suppressive therapy) with azole antifungals to prevent OPC among HIV-infected individuals has been extensively assessed [864, 1444, 2162]. Such therapy is effective, but this form of long-term treatment has created the perfect setting for emergence of resistance [159, 1402, 1403, 1404, 1458]. Candida spp. resistant to antifungal agents become common after several years of therapy [1744, 1912].

    Importantly, a remarkable reduction of the rate of all opportunistic infections, including OPC, was seen upon the introduction of combination therapy and particularly, highly active antiretroviral therapy (HAART) [1457, 1707, 2499]. Indeed, resolution of OPC solely in response to initiation of HAART has been noted. Thus, the observation of OPC in an AIDS patient in the modern era implies a need for both better antiretroviral therapy and for initiation of antifungal therapy.

  2. Continuous vs. Intermittent therapy of Oropharyngeal candidiasis in AIDS patients
    In general, routine prophylaxis of mucosal candidiasis, particularly OPC, has been discouraged [79, 103, 1912]. Three reasons exist for which the United States Public Health Service (USPHS) and the Infectious Disease Society of America (IDSA) have made this recommendation. Two of them have remained unchanged during the entire HIV epidemic. First, OPC is a condition associated with a very low mortality. Second, OPC usually has a very good response to standard therapy.

    The third reason is the all-too-real possibility that prolonged therapy will induce antifungal resistance [1912]. This issue has been instead the subject of intense evaluation. Multiple observations have demonstrated that this event is frequent [159, 1402, 1403, 1404, 1458]. On the other hand, it has also been shown that antifungal agents can reduce the rate of relapse and colonization [1834, 2060]. This theoretical quandry has had, in most instances, a relatively practical solution--frequent relapses were treated with frequent therapy, and at some point frequent therapy becomes (nearly) continuous in any given patient.

    The publication of a prospective randomized study on this topic provides a helpful perspective. Revankar et al. compared the use of continuous and intermittent suppressive therapy in patients with frequent and recurrent episodes of candidal esophagitis [1901]. A reduction in the rate of both relapses and colonization was seen with both regimens. While microbiologic resistance did develop in some patients, therapeutic responses generally remained excellent. The key difference between this study and early reports was the usage of effective antiretroviral therapy. The fact that many of the patients benefit to at least some extent may explain these results.

    In part as a consequence of this work, the 1999 USPHS/IDSA Guidelines for the Prevention of Opportunistic Infections in Persons infected with HIV recommends considering the use of an oral azole (fluconazole or itraconazole solution) when "recurrences are frequent or severe" [80]. But, it should also be kept in mind that the best therapy for OPC is not an antifungal agent--every effort to provide an effective antiretroviral regimen should be made as this is the only therapy that provides true and long-lasting relief.

  3. Denture-Related OPC
    Dentures permit the accumulation of yeast between mucosal surfaces and the prosthesis. Local factors like trauma, maceration and endogenous epithelial changes related to the prosthesis (atrophy, hyperplasia, dysplasia) affect the barrier mechanism of the mucosa [336]. As a consequence, denture wearers often complain of sore and irritated gums. Although bacterial infection, mechanical irritation, and allergic reaction have been proposed as possible causes, infection with Candida spp. has often been implicated. This syndrome is referred to as candidal stomatitis, and rates as high as 65% have been reported. [336].

    Effective therapy requires treatment of both the mouth and the denture. Elimination of fungal colonization of the denture may be difficult. Regular and extensive cleaning of the denture is helpful [2388]. Five-minute irradiation of the denture (immersed in water) in a 60 Hz microwave oven is very successful to eradicate Candida from dentures. However, modification of denture hardness may occur when using this method [600]. Regular cleansing and soaking of dentures in 0.25% chlorhexidine in combination with an antifungal regimen is an alternative strategy that has been described [1007]. Consistent usage of topical antiseptics such as Listerine and Peridex may also be useful in prevention of recurrence [1507].


79. Anonymous. 1997. 1997 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Ann. Intern. Med. 127:922-46.

80. Anonymous. 1999. 1999 USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. U.S. Public Health Service (USPHS) and Infectious Diseases Society of America (IDSA). MMWR Morb Mortal Wkly Rep. 48:1-59, 61-6.

103. Anonymous. 1995. USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus: disease-specific recommendations. USPHS/IDSA Prevention of Opportunistic Infections Working Group. Clin Infect Dis. 21 Suppl 1:S32-43.

159. Baily, G. G., F. M. Perry, D. W. Denning, and B. K. Mandal. 1994. Fluconazole resistant candidosis in an HIV cohort. AIDS. 8:787-792.

171. Barbaro, G., G. Barbarini, W. Calderon, B. Grisorio, P. Alcini, and G. Di Lorenzo. 1996. Fluconazole versus itraconazole for Candida esophagitis in acquired immunodeficiency syndrome. Candida esophagitis. Gastroenterology. 111:1169-1177.

257. Blatchford, N. R. 1990. Treatment of oral candidosis with itraconazole: a review. J. Amer. Acad. Dermatol. 23:565-567.

268. Bodey, G. P. 1986. Candidiasis in cancer patients. Am. J. Med. 77:13-19.

318. Brawner, D. L., and J. E. Cutler. 1989. Oral Candida alibcans isolates from nonhospitalized normal carriers, immunocompetent hospitalized patients, and immunocompromised patients with or without acquired immunodeficiency syndrome. J. Clin. Microbiol. 27:1335-1341.

336. Budtz-Jorgensen, E., A. Stenderup, and M. Grabowski. 1975. An epidemiological study of yeasts in elderly denture wearers. Community Dental Oral Epidemiology. 3:115-119.

470. Cooke, B. E. 1975. Median rhomboid glossitis. Candidiasis and not a developmental anomaly. Br J Dermatol. 93:399-405.

539. de Repentigny, L., and J. Ratelle. 1996. Comparison of itraconazole and ketoconazole in HIV-positive patients with oropharyngeal or esophageal candidiasis.Human Immunodeficiency Virus Itraconazole Ketoconazole Project Group. Chemotherapy. 42:374-83.

543. De Wit, S., D. Weerts, H. Goossens, and N. Clumeck. 1989. Comparison of fluconazole and ketoconazole for oropharyngeal candidiasis in AIDS. Lancet. 1 (8641):746-748.

600. Dixon, D. L., L. C. Breeding, and T. A. Faler. 1999. Microwave disinfection of denture base materials colonized with Candida albicans. J Prosthet Dent. 81:207-14.

722. Feigal, D. W., M. H. Katz, D. Greenspan, J. Westenhouse, W. Winkelstein, Jr., W. Lang, M. Samuel, S. P. Buchbinder, N. A. Hessol, A. R. Lifson, G. W. Rutherford, A. Moss, D. Osmond, S. Shiboski, and J. S. Greenspan. 1991. The prevalence of oral lesions in HIV-infected homosexual and bisexual men: three San Francisco epidemiological cohorts. AIDS. 5:519-525.

733. Finlay, P. M., M. D. Richardson, and A. G. Robertson. 1996. A comparative study of the efficacy of fluconazole and amphotericin B in the treatment of oropharyngeal candidosis in patients undergoing radiotherapy for head and neck tumours. Brit. J. Oral Maxillofac. Surg. 34:23-25.

747. Flynn, P. M., C. K. Cunningham, T. Kerkering, A. R. San Jorge, V. B. Peters, P. A. Pitel, J. Harris, G. Gilbert, L. Catagnaro, P. Robinson, and the Multicenter Fluconazole Study Group. 1995. Oropharyngeal candidiasis in immunocompromised children: a randomized, multicenter study of orally administered fluconazole suspension versus nystatin. J. Pediatr. 127:322-328.

864. Goldman, M., G. A. Cloud, M. Smedema, A. LeMonte, P. Connolly, D. S. McKinsey, C. A. Kauffman, B. Moskovitz, and L. J. Wheat. 2000. Does long-term itraconazole prophylaxis result in in vitro azole resistance in mucosal Candida albicans isolates from persons with advanced human immunodeficiency virus infection? Antimicrob. Agents Chemother. 44:1585-1587.

895. Graybill, J. R., J. Vazquez, R. O. Darouiche, R. Morhart, D. Greenspan, C. Tuazon, L. J. Wheat, J. Carey, I. Leviton, R. G. Hewitt, R. R. MacGregor, W. Valenti, M. Restrepo, and B. L. Moskovitz. 1998. Randomized trial of itraconazole oral solution for oropharyngeal candidiasis in HIV/AIDS patients. Am. J. Med. 104:33-39.

899. Greenspan, D. 1994. Treatment of oropharyngeal candidiasis in HIV-positive patients. J. Amer. Acad. Dermatol. 31 (Suppl. 2):S51-S55.

1007. Hay, R. J., Y. M. Clayton, M. K. Moore, and G. Midgely. 1988. An evaluation of itraconazole in the management of onychomycosis. Br. J. Dermatol. 119:359-66.

1035. Hernandez-Sampelayo, T. 1994. Fluconazole versus ketoconazole in the treatment of oropharyngeal candidiasis in HIV-infected children. Multicentre Study Group. Eur. J. Clin. Microbiol. Infect. Dis. 13:340-4.

1132. Johnson, G. H., T. D. Taylor, and D. W. Heid. 1989. Clinical evaluation of nystatin pastille for treatment of denture-related oral candidiasis. J Prosthet Dent. 61:699-703.

1197. Kirkpatrick, C. H. 1994. Chronic mucocutaneous candidiasis. J. Amer. Acad. Dermatol. 31 (Suppl. 2):S14-S17.

1214. Klein, R. S., C. A. Harris, C. B. Small, B. Moll, M. Lesser, and G. H. Friedland. 1984. Oral candidiasis in high-risk patients as the initial manifestation of the acquired immunodeficiency syndrome. N. Engl. J. Med. 311:354-358.

1223. Koletar, S. L., J. A. Russell, R. J. Fass, and J. F. Plouffe. 1990. Comparison of oral fluconazole and clotrimazole troches as treatment for oral Candidiasis in patients infected with human immunodeficiency virus. Antimicrob. Agents Chemother. 34:2267-2268.

1255. Krogh, P., P. Holmstrup, P. Vedtofte, and J. J. Pindborg. 1986. Yeast organisms associated with human oral leukoplakia. Acta Derm Venereol Suppl. 121:51-5.

1283. Laine, L., R. H. Dretler, C. N. Conteas, C. Tuazon, F. M. Koster, F. Sattler, K. Squires, and M. Z. Islan. 1992. Fluconazole compared with ketoconazole for the treatment of Candida esophagitis in AIDS: A randomized trial. Ann. Intern. Med. 117:655-660.

1402. Maenza, J. R., J. C. Keruly, R. D. Moore, R. E. Chaisson, W. G. Merz, and J. E. Gallant. 1996. Risk factors for fluconazole-resistant candidiasis in human immunodeficiency virus-infected patients. J. Infect. Dis. 173:219-225.

1403. Maenza, J. R., W. G. Merz, M. J. Romagnoli, J. C. Keruly, R. D. Moore, and J. E. Gallant. 1997. Infection due to fluconazole-resistant Candida in patients with AIDS: Prevalence and microbiology. Clin. Infect. Dis. 24:28-34.

1404. Maenza, J. R., W. G. Merz, M. J. Romagnoli, J. C. Keruly, R. D. Moore, and J. E. Gallant. 1995. Prevelance of fluconazole-resistant candidiasis in HIV-infected patients. 33rd Annual Meeting of the Infectious Diseases Society of America, Abstract No. 323.

1444. Marriott, D. J., P. D. Jones, J. F. Hoy, B. R. Speed, and J. L. Harkness. 1993. Fluconazole once a week as secondary prophylaxis against oropharyngeal candidiasis in HIV-infected patients. Med. J. Aust. 158:312-316.

1457. Martins, M. D., M. Lozano-Chiu, and J. H. Rex. 1998. Declining rates of oropharyngeal candidiasis and carriage of Candida albicans associated with trends toward reduced rates of carriage of fluconazole-resistant C. albicans in human immunodeficiency virus-infected patients. Clin Infect Dis. 27:1291-1294.

1458. Martins, M. D., M. Lozano-Chiu, and J. H. Rex. 1997. Point prevalence of carriage of fluconazole-resistant Candida in the oropharynx of HIV-Infected patients. Clin. Infect. Dis. 25:843-846.

1507. Meiller, T. F., J. I. Kelley, M. A. Jabra-Rizk, L. G. DePaola, A. Baqui, and W. A. Falkler, Jr. 2001. In vitro studies of the efficacy of antimicrobials against fungi. Oral Surg Oral Med Oral Patho. 91:663-670.

1567. Montes, L. F., T. G. Soto, J. M. Parker, and G. N. Ramer. 1976. Clotrimazole troches: a new therapeutic approach to oral candidiasis. Cutis. 17:277-80.

1672. Odds, F. C. 1988. Candida and Candidosis, 2nd ed. Bailliere Tindall, London.

1707. Palella, F. J., Jr., K. M. Delaney, A. C. Moorman, M. O. Loveless, J. Fuhrer, G. A. Satten, D. J. Aschman, S. D. Holmberg, and HIV Outpatient Study Investigators. 1998. Declining mortality and morbidity among patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 338:853-860.

1744. Pelletier, R., J. Peter, C. Antin, C. Gonzalez, L. Wood, and T. J. Walsh. 2000. Emergence of resistance of Candida albicans to clotrimazole in human immunodeficiency virus-infected children: In vitro and clinical correlations. J Clin Microbiol. 38:1563-8.

1788. Phillips, P., K. De Beule, G. Frechette, S. Tchamouroff, B. Vandercam, L. Weitner, A. Hoepelman, G. Stingl, and B. Clotet. 1998. A double-blind comparison of itraconazole oral solution and fluconazole capsules for the treatment of oropharyngeal candidiasis in patients with AIDS. Clin. Infect. Dis. 26:1368-1373.

1824. Pons, V., D. Greenspan, M. Debruin, and the Multicenter Study Group. 1993. Therapy for oropharyngeal candidiasis in HIV-infected patients: A randomized, prospective multicenter study of oral fluconazole versus clotrimazole troches. Journal of Acquired Immune Deficiency Syndromes. 6:1311-1316.

1825. Pons, V., D. Greenspan, F. Lozada-Nur, L. McPhail, J. E. Gallant, A. Tunkel, C. C. Johnson, J. McCarty, H. Panzer, M. Levenstein, A. Barranco, and S. Green. 1997. Oropharyngeal candidiasis in patients with AIDS: Randomized comparison of fluconazole versus nystatin oral suspensions. Clin. Infect. Dis. 27:1204-1207.

1834. Powderly, W. G., D. M. Finkelstein, J. Feinberg, P. Frame, W. He, C. van der Horst, S. L. Koletar, M. E. Eyster, J. Carey, H. Waskin, T. M. Hooton, N. Hyslop, S. A. Specton, S. A. Bozzette, and the NIAID AIDS Clinical Trials Group. 1995. A randomized trial comparing fluconazole with clotrimazole troches for the prevention of fungal infections in patients with advanced human immunodeficiency virus infection. N. Engl. J. Med. 332:700-705.

1900. Revankar, S. G., W. R. Kirkpatrick, R. K. McAtee, O. P. Dib, A. W. Fothergill, S. W. Redding, M. G. Rinaldi, and T. F. Patterson. 1996. Detection and significance of fluconazole resistance in oropharyngeal candidiasis in human immunodeficiency virus-infected patients. J. Infect. Dis. 174:821-827.

1901. Revankar, S. G., W. R. Kirkpatrick, R. K. McAtee, A. W. Fothergill, S. W. Redding, M. G. Rinaldi, S. G. Hilsenbeck, and T. F. Patterson. 1998. A randomized trial of continuous or intermittent therapy with fluconazole for oropharyngeal candidiasis in HIV-infected patients: Clinical outcomes and development of fluconazole resistance. Am. J. Med. 105:7-11.

1912. Rex, J. H., M. G. Rinaldi, and M. A. Pfaller. 1995. Resistance of Candida species to fluconazole. Antimicrob. Agents Chemother. 39:1-8.

1929. Rindum, J. L., A. Stenderup, and P. Holmstrup. 1994. Identification of Candida albicans types related to healthy and pathological oral mucosa. J Oral Pathol Med. 23:406-12.

2012. Samaranayake, L. P., and H. B. Yaacob. 1990. Classifications of oral candidosis, p. chap 7. In L. P. Samaranayake and T. W. MacFarlane (ed.), Oral Candidosis, vol. 1st ed. Wright, London.

2025. Sangeorzan, J. A., S. F. Bradley, X. He, L. T. Zarins, G. L. Ridenour, R. N. Tiballi, and C. A. Kauffman. 1994. Epidemiology of oral candidiasis in HIV-infected patients: Colonization, infection, treatment, and emergence of fluconazole resistance. Am. J. Med. 97:339-346.

2060. Schuman, P., L. Capps, G. Peng, J. Vazquez, W. el-Sadr, A. I. Goldman, B. Alston, C. L. Besch, A. Vaughn, M. A. Thompson, M. N. Cobb, T. Kerkering, and J. D. Sobel. 1997. Weekly fluconazole for the prevention of mucosal candidiasis in women with HIV infection. A randomized, double-blind, placebo-controlled trial. Terry Beirn Community Programs for Clinical Research on AIDS [see comments]. Ann. Intern. Med. 126:689-96.

2091. Shechtman, L. B., L. Funaro, T. Robin, E. J. Bottone, and J. Cuttner. 1984. Clotrimazole treatment of oral candidiasis in patients with neoplastic disease. Am. J. Med. 76:91-4.

2162. Stevens, D. A., S. I. Greene, and O. S. Lang. 1991. Thrush can be prevented in patients with acquired immunodeficiency syndrome and the acquired immunodeficiency syndrome--related complex. Randomized, double-blind, placebo-controlled study of 100-mg oral fluconazole daily. Arch. Intern. Med. 151:2458-2464.

2224. Tapper-Jones, L. M., M. J. Aldred, D. M. Walker, and T. M. Hayes. 1981. Candidal infections and populations of Candida albicans in mouths of diabetics. J. Clin. Pathol. 34:706-711.

2300. Vazquez, J. A., and J. D. Sobel. 1995. Fungal infections in diabetes. Infectious Diseases Clinics of Nort America. 9:97-116.

2322. Vidas, I., K. Temmer, P. Zuzic, and M. Palaversic. 1988. [Candida albicans in leukokeratotic lesions of oral mucosa]. Acta Stomatol Croat. 22:311-7.

2388. Webb, B. C., C. J. Thomas, M. D. Willcox, D. W. Harty, and K. W. Knox. 1998. Candida-associated denture stomatitis. Aetiology and management: a review. Part 1. Factors influencing distribution of Candida species in the oral cavity. Aust Dent J. 43:45-50.

2470. Yeo, E., T. Alvarado, V. Fainstein, and G. P. Bodey. 1985. Prophylaxis of oropharyngeal candidiasis with clotrimazole. J Clin Oncol. 3:1668-71.

2499. Zingman, B. S. 1996. Resolution of refractory AIDS-related mucosal candidiasis after initation of didanosine plus saquinavir. N. Engl. J. Med. 334:1674-1675.

  Home | Image Bank | Lecture Bank | Knowledgebase | Site Map | Contact Us |
The Fungi | Mycoses | Drugs |
Laboratory | Education & Tools | About Us's sponsors