What are Fungal Infections of the Oral Cavity?

Fungal Infections of the Oral Cavity
Histopathology of tongue sections at 4x magnification (top) and (400x magnification) bottom from A. Vehicle control, B. Positive control treated with nystatin, and C. Lichochalcone-A. Circles on top images shows a section of the epithelium layer that is enlarged below at 400x magnification. Tongue section (A, left panel) from vehicle control showed yeasts and hyphae (arrows) invasion of the dorsal papillary architecture. Presence of C. albicans is indicated by arrows pointing to pink staining (A, lower left). Tongue sections from panel B, positive control, and panel C, lichochalcone-A, did not show signs of fungal burden. In Vitro and In Vivo Antifungal Activity of Lichochalcone-A against Candida albicans Biofilms. Seleem D, Benso B, Noguti J, Pardi V, Murata RM - PloS one (2016). Not Altered. CC.

Fungal infections of the oral cavity are the fungal infections that manifest within the oral cavity

Examples of fungal infections of the oral cavity include:

  • Deep fungal infections
  • Aspergillosis
  • Blastomycosis
  • Coccidioidomycosis
  • Cryptococcosis
  • Histoplasmosis
  • Zygomycosis
FUNGAL INFECTIONHISTOLOGYPRESENTATIONTREATMENTPROGNOSIS
ASPERGILLOSISHyphae that are uniform, narrow (3 to 6 micrometers in width), tubular, and regularly septate. Branching is regular, progressive, and dichotomous. Fever, cough, dyspnea, pleuritic chest pain, and sometimes hemoptysis in patients with prolonged neutropenia or immunosuppression. Aspergillus infection after organ transplantation most often occurs in bone marrow recipients.Oral corticosteroids, Antifungal medications, SurgeryPrognosis is poor
BLASTOMYCOSISBroad verrucous lesion with epidermal papillomatosis which may resemble a keratoacanthoma. There may be surface erosion and suppuration. Numerous cystic spaces connect with the surface via draining sinuses.Flu-like illness with fever, chills, myalgia, headache, chest pain, and a nonproductive coughAntifungal medication. Variable
COCCIDIOIDOMYCOSISPseudoepitheliomatous hyperplasia of epidermis and adjacent or admixed acute suppurative inflammation. Variable infiltrate of neutrophils, eosinophils, histiocytes, multinucleated giant cells, plasma cells and rarely lymphocytes are present·   Reactive and organism-specific reactive manifestations do not contain visible microorganisms and may exhibit features of erythema nodosum, Sweet syndrome, and interstitial granulomatous dermatitis. Rarely, patients may exhibit features of erythema multiforme, acute generalized exanthema, secondary to hypersensitivity to systemic infectionFluconazole or another type of antifungal medication.Good
CRYPTOCOCCOSISVariably sized (3.5 – 8 μm in diameter)·   Round to oval encapsulated yeasts with thin cell walls· ·Opportunistic infection·Liposomal amphotericin B Good
HISTOPLASMOSISYeast forms (2 – 5 um) with basophilic crescent-shaped nuclei Diarrhea, bleeding, pain, nausea, vomiting, flu-like symptoms Itraconazole Amphotericin for disseminated disease Variable
ZYGOMYCOSISCoagulative necrosis due to fungi with broad, sparsely septate, thin-walled hyphae· Necrosis Amphotericin B or newer drugs·   Surgical debridement Poor prognosis
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Last updated on May 23, 2022