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Case 176

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Two weeks ago, a 23-year-old female patient, previously healthy and without comorbidities, developed whitish lesions as a cream film covering tongue and palate, associated with sore throat (Figure 1).

Considering the image and case report presented, we can state that are risk factors for the condition shown above, EXCEPT:

a) Unprotected oral sex.

25%

b) Chronic inhaled corticosteroids therapy.

25%

c) Acquired Immunodeficiency Syndrome.

25%

d) Broad-spectrum antibiotic therapy.

25%
   

Image Analysis

Imagem 1: Whitish plaques similar to "curd" localised under the tongue. Dental arch with irregular deployment, poor conservation state, loss of teeth and exposure of the teeth root.

Highlights

- Oral candidiasis can be seen in infants and adults under immunosuppression, as in wide-spectrum antibiotics, chemotherapy, radiotherapy in head and neck, chronic inhaled corticosteroids or acquired immunodeficiency syndrome.

- Oral candidiasis presents as adherent white plaques on the oral mucosa and tongue, and when these plaques are removed, it reveals an intense painful erythema.

- Oral candidiasis has the following important differential diagnoses to be remembered: lichen planus in the mucosa, oral hairy leukoplakia and oral cancer.

References

- Veronesi R, Focaccia R. Tratado de infectologia. 4ª edição. Ed.Atheneu. São Paulo. 2009. Vol.1. p.9 - 23, p.171 e p.176.

- Veronesi R, Focaccia R. Tratado de infectologia. 4ª edição. Ed.Atheneu. São Paulo. 2009. Vol.2. p.1493 - 1505.

- UpToDate. http://www.uptodate.com/contents/overview-of-candida-infections?source=preview&search=moniliase&selectedTitle=1~150&language=en-US&anchor=H3#H3. Access in 21nov. 2014.

Author

Lucas Vieira Rodrigues. 5th year medical student at UFMG School of Medicine. Email: 

lucasvrvr[at]gmail.com

Supervisor

Ana Elisa Tavares Diniz. General practitioner, physician at Belo Horizonte. Email anaelisatd [at] gmail.com

Reviewers

André Guimarães, Júlio Guerra, Hércules Hermes Riani and Viviane Parisotto.

Translated by

Ana Júlia Furbino Dias Bicalho, 6th year medical student at UFMG School of Medicine.

Email: anajuliabicalho[at]gmail.com

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