Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0006849 (oral candidiasis)
 1,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Of about 40 patients with presumed enteropathic Acquired Immune Deficiency Syndrome (AIDS), i.e., oral thrush, diarrhea, and weight loss, admitted to Mulago Hospital medical wards, Uganda, from October through November 985, 23 patients were studied with upper gastrointestinal tract endoscopy and stool examination. Those patients chosen for study suffered with diarrhea, weight loss, and oral candidiasis and were willing to tolerate endoscopy. Weight loss was not quantified in most patients, but generally it was profound. 10 of the patients gave a history of genital sores or venereal disease. There were 16 males and 7 females with an age range of 19-47 years. All were sexually active, and all denied homosexuality anal intercourse, and intravenous drug abuse. 4 patients had had blood transfusion. The 23 patients represented a cross-section of the population with most social classes included. 20 patients were seropositive with antibody to HIV. Specimens from 2 patients were lost. 1 patient was seronegative. Apart from 5 patients who had been treated with nystatin for oral thrush and clinically presumed esophageal candidiasis, all the patients had oral thrush at the time of endoscopy. 20 patients had obvious esophageal candidiasis, and 1 patient had the appearance of Kaposi's sarcoma in the esophagus. Stool examination and histology of the upper GI tract showed that 11 patients had cryptosporidiosis and 3 had isosporiasis (total of 61% of patients with coccidian enteritis). 1 case of Mycobacterium avium mycobacteriosis also was identified. The incidence of cryptosporidiosis and isosporiasis is higher in Uganda than in developed countries.
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PMID:Enteropathic AIDS in Uganda. An endoscopic, histological and microbiological study. 312 96

A prospective, randomized, controlled, double-blind study was performed between 1982 and 1985 to assess the ability of ketoconazole to prevent fungal infections in selected patients with cancer. Fifty-six patients receiving induction chemotherapy for acute leukemia, autologous bone marrow transplant for refractory nonhematopoietic malignant neoplasms, multidrug chemotherapy for malignant lymphoma, or corticosteroids for brain metastases were randomized to receive either oral ketoconazole, 400 mg/d, or placebo and observed until leukopenia resolved or corticosteroid therapy was stopped. Oral candidiasis developed in eight (28%) of 29 patients receiving placebo compared with none of 27 receiving ketoconazole. However, ketoconazole failed to prevent Candida esophagitis and vulvovaginitis in two patients and one patient, respectively. Furthermore, prophylactic use of ketoconazole did not significantly alter the total number of hospital days, febrile days, or antibiotic days or the requirement for amphotericin B in patients with acute leukemia and autologous bone marrow transplant. Since oral candidiasis can be successfully managed by several different treatment modalities when it does occur, we do not think that the routine prophylactic use of ketoconazole is justified.
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PMID:Ketoconazole in the prevention of candidiasis in patients with cancer. A prospective, randomized, controlled, double-blind study. 354 26

Oral Candida and Candida esophagitis are common findings in patients with the acquired immune deficiency syndrome. The intestinal protozoan, Cryptosporidium, is known to cause gastrointestinal symptoms in these patients. We report a 2-yr-old child with acquired immune deficiency syndrome, who had oral candidiasis, dysphagia, and vomiting. Upper gastrointestinal endoscopy and esophageal biopsy led to a diagnosis of esophageal cryptosporidiosis. We recommend upper gastrointestinal endoscopy as a diagnostic tool in selected patients with acquired immune deficiency syndrome. This is in contradistinction to a previous report that concludes that endoscopy is not necessary in this setting.
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PMID:Esophageal cryptosporidiosis in a child with acquired immune deficiency syndrome. 375 22

Fourteen previously healthy young patients with unusual community-acquired opportunistic infections were seen over a period of three years. They differ from patients previously described in that 11 were heterosexual drug abusers (including two women) and only three were homosexual men. There were eight Puerto Ricans, five blacks, and one white. Infections included Pneumocystis carinii pneumonia (seven), disseminated Mycobacterium intracellulare infection, histoplasmosis, cryptococcosis, and cytomegalovirus infection (one each), oral thrush (13), and Candida esophagitis (two). All patients had impaired cellular immunity manifested by cutaneous anergy and lymphopenia, and all 11 tested had a markedly decreased ratio of T helper/inducer cells to T suppressor/cytotoxic cells. Twelve had evidence of associated viral infection (Epstein-Barr virus in nine, cytomegalovirus in five, Herpes simplex type 2 in two). Clinical presentation was with a severe opportunistic infection or with a prodrome consisting of oral thrush and nonspecific findings including malaise, fever, lymphadenopathy, or cough. The syndrome of immunodeficiency and opportunistic infection occurs in nonwhite heterosexual drug abusers, not exclusively in white homosexual men, and patients may present for medical care before the onset of a severe opportunistic infection.
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PMID:Community-acquired opportunistic infections and defective cellular immunity in heterosexual drug abusers and homosexual men. 621 79

A 14-day old infant with stomatitis due to Candida albicans presented with frequent emesis and was found to have esophagitis by barium esophagram. She responded promptly to oral Mycostatin suspension: her emesis subsided and the stomatitis resolved. Repeat esophagram on the seventh day of therapy showed complete resolution of the esophageal mucosal abnormalities. Although Candida stomatitis is common in infants, the incidence and appropriate therapy of Candida esophagitis as a complication in otherwise normal infants are unknown. This patient responded well to frequent therapy with an oral, nonabsorbable antifungal agent.
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PMID:Esophagitis associated with Candida infection in a neonate. 669 25

Dysphagia and retrosternal pain are common complaints in patients after cardiac operations, and most often they result from the median sternotomy and/or endotracheal intubation. Although Candida esophagitis is a recognized cause of similar symptoms, it is usually not suspected except in immunologically compromised hosts. This report describes the case histories of five patients, not immunosuppressed or cachectic, who developed persistent dysphagia during recovery from cardiac operations; four patients received only 4 days of preoperative and postoperative prophylactic antibiotic treatment with cefazolin (Kefzol) and cephalexin (Keflex). A nasogastric tube had been used for less than 24 hours in the postoperative period. The fifth patient developed symptoms following prolonged and varied antibiotic therapy. Candida esophagitis was diagnosed by a combination of coexisting oral candidiasis (5/5), roentgenographic appearance on barium swallow (5/5), endoscopy (4/4), and biopsy or culture (2/4). Initial therapy consisted of antireflux measures and antacids (4/5), cimetidine (4/5), oral nystatin in methylcellulose base (1,000,000 units every 4 hours) (4/5), and termination of other antibiotic therapy (1/5). These measures were effective in clearing the infection in only two patients. A third patient required prolonged massive oral nystatin therapy, and in two patients intravenous Amphotericin B was necessary to control infection. Two patients subsequently developed strictures which necessitated multiple esophageal dilatations. One of these patients developed endocarditis during home dilatation therapy. All patients are currently free of disease. Current measures utilized to recognize and treat the disease are discussed.
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PMID:Candida esophagitis following cardiac operation and short-term antibiotic prophylaxis. 743 63

Significant hemorrhage from esophageal candidiasis in patients without a major bleeding diathesis is extremely uncommon. A case of recurrent, severe upper gastrointestinal bleeding due to hemorrhagic candidal esophagitis in a man with renal failure is described. Dysphagia, odynophagia, and retrosternal chest discomfort were all absent. Oral thrush was present only at the outset. Standard therapy for massive bleeding with blood products alone was not successful. Intravenous amphotericin eventually resulted in resolution.
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PMID:Massive upper gastrointestinal bleeding due to Candida esophagitis. 820 82

Endoscopic experience in patients with acquired immunodeficiency syndrome (AIDS) has rarely been reported in Taiwan. We present our experience in 9 AIDS patients (8 male and 1 female, age from 26 to 63 years) with 12 examinations. The risk factor of these patients were bisexual in 3, homosexual in 2, hemophilia in 1, drug abuse in 1, and paid-sex in 2. Odynophagia or dysphagia was the major complaints. Oral ulcers or/and thrush were noted in 8 patients. Endoscopic findings included negative (6/12), candidiasis (3/12), erosions (1/12), ulcers (1/12) and ulcer scar (1/12) in esophagus; negative (8/12), gastritis (1/12), erosions (1/12), ulcers (1/12) and Kaposi's sarcoma (1/12) in stomach; and negative (11/12) and duodenitis (1/12) in duodenum. Patients with esophageal candidiasis always had oral thrush. Dysphagia was highly correlated with positive endoscopic findings in esophagus. It is important for an endoscopist to identify clinical symptoms and to examine patient's oral cavity before an endoscopic examination. The endoscopist must keep himself from being infected by exposure to contaminated blood and secretion and avoid dissemination of this horrible disease by undisinfected instruments.
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PMID:Endoscopic examination in patients with acquired immunodeficiency syndrome: Taiwan experience. 840 71

Azole-resistant oropharyngeal and oesophageal candidiasis is a recent phenomenon observed in patients with AIDS usually previously treated with fluconazole. Some variation has been observed in antifungal susceptibility testing among separate colonies of Candida albicans from the same patient. This raises the question of whether there are multiple clones present or simply phenotypic variation in expression of azole resistance. To address this question we took 18 isolates grown from multiple swabs taken before and after experimental azole therapy from a single HIV-positive individual with fluconazole-resistant oral candidiasis and compared morphotype, karyotype, PCR-based DNA typing and azole susceptibility. Ten of the isolates were from a single 2-day period. Amongst these 10 there were seven morphotypes, five karyotypes and four polymerase chain reaction (PCR) types. Three further morphotypes, one karyotype and two PCR types were found amongst the eight isolates obtained during the subsequent 4 months. Limited variation in susceptibility to two azoles--fluconazole and D0870--was also seen. This work emphasizes both the large genotype and phenotypic variability of C. albicans isolates in the mouth of AIDS patients with fluconazole resistance, and the difficulties in interpretation of present typing methods.
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PMID:Variation in morphotype, karyotype and DNA type of fluconazole resistant Candida albicans from an AIDS patient. 951 70

The present study was designed to determine the frequency of candidal esophagitis in cancer patients with oral thrush. Patients with clinically and microbiologically diagnosed oral candidiasis were evaluated by endoscopy for concurrent esophageal candidiasis. Esophageal involvement was documented by mucosal lesions, microbiological findings of candidal infection in smears of brushing material, positive cultures of brushing material, and histological evidence of mucosal invasion by the yeast. For 21 of the 22 patients studied, there were endoscopic and microbiological findings of candidal esophagitis. Cultures of the brushing material from all 22 patients were positive, while histological evidence was found for 14 patients. Only 10 of the patients had mild esophageal symptoms. It is concluded that oral thrush represents a reliable marker for esophageal candidiasis in patients with cancer. Routine endoscopy is not necessary to confirm the diagnosis; this procedure should be reserved for patients with persistent thrush and symptoms despite antifungal therapy.
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PMID:Oropharyngeal candidiasis as a marker for esophageal candidiasis in patients with cancer. 970 77


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