Israyani1, Nur Tsurayya2, Bagus Soebadi3, Hening tuti Hendarti3, Adiastuti EP3, Azimatul Kharimah4

Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia

Faculty of Dental Medicine, Hang Tuah University, Surabaya, Indonesia

Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia

Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Abstract

Introduction: Oral candidiasis is a commonly-found infection in AIDS patients which can leave the patient feeling depressed. The pathogenesis of AIDS is characterised by a decrease in CD4+ levels that leaves a patient susceptible to other infections. The purpose of this paper is to report a case of oral candidiasis in a young man living with HIV/AIDS as well as a psychological disorder.

Case: The 27-year-old male patient complained of increased thickness that had affected the surface of the oral cavity for the past six months. The patient had been  diagnosed with HIV two years earlier and had previously attempted suicide on several occasions. The clinical features indicated the presence of white plaques covering almost all of the oral cavity. They did scrape off.

Discussion: A fungal test demonstrated the presence of yeast formation, while blood picture showed an increase in blood sedimentation rate. Oral candidiasis for two years in a patient with HIV/AIDS. Patient attempted suicide five times and had been referred for psychiatric assessment and the results indicated a bipolar affective disorder now with severe depression with psychotic symptoms (F31.5). The patient was referred to the Infectious [disease] Care Unit RSUA for antiretroviral therapy (ART). The oral candidiasis was treated using nystatin drops and azole-type systemic fungal drugs.

Conclusion: Diagnosis of oral candidiasis in patient with HIV/AIDS is based on the clinical features, and supporting examinations. Treatment of oral candidiasis in HIV/AIDS patients requires the patient to be taking systemic antiretrovirals in addition to treating the fungal disease with medications that that do not exacerbate any existing psychological disorders. Good collaboration is needed between the clinicians managing both the oral and psychiatric diseases.