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08-Jul-2004
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Arch Hellen Med, 20(1), January-February 2003, 49-56 ORIGINAL PAPER Oral candidiasis in patients with hematological malignancies O. NICOLATOU-GALITIS,1 S. PAIKOS,2
S. KOKORI,3 |
OBJECTIVE Study of the clinical forms of oropharyngeal candidiasis in patients with hematological malignancies during their hospitalization.
METHOD Eighty-eight patients aged between 18–88 years were included in the study. The patients were hospitalized in the “Laiko” Ηospital for the treatment of hematological malignancies. Their oral mucosa was examined weekly. Antineoplastic chemotherapy was administered during the study to 36 patients. Smears were taken from the lesions when oral candidiasis was diagnosed clinically, and antimycotic treatment was administered per os. The clinical diagnosis was confirmed in every case by the laboratory findings and by the clinical response of the patients to antimycotic treatment. The smears were studied in the Mycology Reference Laboratory of the Department of Microbiology, at the University of Athens School of Medicine.
RESULTS Twenty-two cases of oral candidiasis were diagnosed in 19 (25%) of the 88 patients. Candidiasis developed in 12 of the 36 patients who were under antineoplastic chemotherapy at the time of oral examination and in 7 of the 52 patients who did not receive chemotherapy (Ρ=0.035). Drop-like pseudomembranous candidiasis was diagnosed in 13 patients, while erythematous oral candidiasis and angular cheilitis were observed in 6 patients. Candida albicans was isolated from 20 clinical specimens and C. tropicalis from two specimens. All of the patients responded well to antimycotic treatment.
CONCLUSIONS Pseudomembranous, erythematous candidiasis and angular cheilitis were the most common oral mucosal infections. The total incidence of oral candidiasis, including recurrences, was 25%. Antineoplastic chemotherapy significantly increased the risk of development of oral candidiasis. The development of oropharyngeal candidiasis in the patients of this study denotes the need for constant surveillance of the oral mucosa of patients with hematological malignancies during their hospitalization, irrespective of administration of chemotherapy. The good response of the patients to antimycotic treatment underlines the importance of early diagnosis, which is expected to reduce the risk of hematogenous systemic candidiasis.
Key words: Hematological malignancies, Oral candidiasis.
