Candidosis – Fungal infection in the mouth
Candidosis is generally understood to be an infectious disease caused by fungi of the genus Candida. Oral thrush (also called Stomatitis candidomycetica) is a candidosis of the mucous membranes of the mouth and possibly the throat. The oral thrush is usually caused by the fungus Candida albicans.
This fungus is a harmless saprophyte in the mucous membrane of the mouth and throat and does not cause disease in healthy people. However, in the case of congenital or acquired immunosuppression (e.g. by HIV, antibiotics, cytostatics or sepsis), the fungus can be infectious and attack the mucous membranes, which then manifests itself as an inflammation in the mouth. The diagnosis is made microscopically with the help of a smear of the mucous membrane.
In order to initiate an adequate therapy, the fungus must be cultivated in a culture. Then the diagnosis is certain. Candidosis of the mouth and throat mucosa is treated with antimycotics such as Econazole, Nystatin, Amphotericin B, Natamycin or Miconazole.
These are applied locally. Disinfecting mouthwashes and cleansing agents such as gels are also available. It is also important to eliminate the cause. If the candidosis, for example, on the floor of an antibiotic treatment developed, the antibiotic should be discontinued or changed.
Habitat Aphthae
This is an inflammation in the mouth that recurs very often. The disease is very painful and non-infectious. It is estimated that up to 25% of the total population suffers from these recurrent aphthae.Many different causes are discussed in connection with the development of habitual aphthae.
It is therefore assumed that habitual aphthae are the manifestation of very different underlying disease patterns. Possible causes are allergies, food intolerances (e.g. nuts and citrus fruits), deficiency symptoms (vitamin B12, iron, folic acid) and small traumas caused by biting the mucous membrane of the mouth and cheeks. In addition, immunological reactions seem to play a role, for example in Behçet’s disease.
Viral infections seem to be involved as well, since the cytomegalovirus can be partially detected in the aphtae. This virus belongs to the herpes virus family. Finally, intolerances to toothpaste ingredients are also a possible cause.
The aphthae show up as sharp oval swellings separated by a red rim, which appear whitish. They can be up to 2 cm in size and usually heal without scarring within 2 weeks. These aphthae are preferably located on the inside of the lips and cheek mucosa.
There may also be aphtae on the tongue and aphtae in the throat. There are various approaches to the treatment of aphthae, which are more or less successful. First of all, avoiding potentially intolerable foods such as nuts can improve the situation.
Antibiotic pastes and mouth rinses (e.g. tetracycline and chlortetracycline) can shorten the duration of the disease. Antiseptic and local anaesthetic mouthwashes can be used to relieve the symptoms of inflammation in the mouth, but this does not shorten the duration of the disease. Anti-inflammatory gels and pastes containing corticoids are also used. Finally, if the course of the disease is very resistant to therapy, systemic therapy with colchicine, dapsone, doxycycline and thalidomide, among others, can be used.