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Oral lesions in the systemic mycoses.

O P de Almeida1, C Scully

  • 1University of Campinas, Piracicaba, Brazil.

Current Opinion in Dentistry
|August 1, 1991
PubMed
Summary

Oral lesions are increasingly seen in immunocompromised individuals due to systemic mycoses like aspergillosis. Dentists should recognize these signs and consider antifungal treatments such as amphotericin or azoles.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Oral Medicine

Background:

  • Oral lesions are uncommon in systemic mycoses but are increasingly reported in immunocompromised individuals.
  • The rise in human immunodeficiency virus (HIV) infections correlates with increased oral manifestations of systemic fungal infections.
  • Specific mycoses like aspergillosis, cryptococcosis, and histoplasmosis show a notable increase in oral presentations.

Purpose of the Study:

  • To highlight the growing association between systemic mycoses and oral lesions in immunocompromised patients.
  • To inform dental professionals about recognizing potential signs of systemic fungal infections in the oral cavity.
  • To discuss current therapeutic approaches for deep and superficial mycoses.

Main Methods:

  • Review of recent case reports and clinical observations regarding oral lesions in systemic mycoses.
  • Analysis of the impact of increased immunocompromised populations, particularly HIV-infected individuals, on the incidence of these infections.
  • Summary of established and emerging antifungal treatment strategies.

Main Results:

  • While aspergillosis, cryptococcosis, and histoplasmosis are increasingly associated with oral lesions in immunocompromised patients, coccidioidomycosis, blastomycosis, and paracoccidioidomycosis have shown less increase.
  • Chronic oral ulcerations, maxillary sinus infections, and unusual mouth lesions in immunocompromised patients may indicate a systemic mycosis.
  • Amphotericin B remains a primary treatment for deep mycoses, with azoles being first-line for superficial mycoses and increasingly used for deep-seated infections.

Conclusions:

  • Systemic mycoses, particularly in immunocompromised individuals, frequently manifest with oral lesions.
  • Awareness among dentists is crucial for early diagnosis and management of these potentially serious infections.
  • Antifungal therapy, including amphotericin and azoles, is essential for treating systemic mycoses with oral involvement.

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