Herlambang Devianto*, Dian Angriany*, Diah  Savitri Ernawati** Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia

Abstract

Introduction Oropharyngeal candidiasis (OPC) is an opportunistic fungal infection that is often found in HIV/AIDS patients. Clinical features that are often encountered in HIV patients with OPC, are thrush, erythematous candidiasis, chronic hyperplastic candidiasis and angular cheilitis (perleche). Candida albicans is the main infecting agent but other species of Candida can also be found.

Case A 27-year-old woman came to Airlangga Hospital complaining about her mouth that felt "thick" following the appearence of a white patch two weeks earlier. Lesions did not respond to treatment with mouthwash and have not healed. The patient claimed to have lost about 5 kg in weight over the past 3 months and have been undergoing glandular TB therapy 6 months earlier. On physical examination the patient looks pale and exhausted. Intraoral examination revealed white pseudomembranes on the surface of the tongue, palate, oropharynx, right and left buccal mucosa: the pseudomembranes had diffuse borders, irregular edges and could be scraped away to leave an erythematous surface. KOH examination, complete blood and anti-HIV were performed. Topical antifungal (Nystatin) and fluconazole tablets were prescribed for therapy after the KOH test results showed positive for Candida albicans in the form of yeast cell and pseudohyphae. On anti-HIV examination, reactive results and CD4 examinations were obtained with a total of 92 cells/µL.

Discussion Based on the results of clinical examinations, OPC features are often associated with low CD4 counts and are a marker of progression for HIV/AIDS disease. Conclusions OPC is a problem for people with HIV/AIDS. Fluconazole is the standard therapy for this complaint. In addition to antifungal therapy Retroviral therapy to control the underlying HIV/AIDS also plays a role in controlling the florid manifestation of Candida albicans.