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Persistent and refractory thrush with unknown cause.

Lili Wang1, Dongjuan Liu, Xin Zhao

  • 1From the *State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan; and †College of Stomatology, Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.

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Summary

Persistent oral thrush, often linked to immunodeficiency, can have unusual causes. This case highlights Klinefelter syndrome as a rare underlying factor in refractory oral fungal infections.

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Area of Science:

  • Mycology
  • Immunology
  • Genetics

Background:

  • Oral thrush (Candida albicans) is an opportunistic infection.
  • Immunodeficiency (HIV, immunosuppressants, antibiotics, transplants) increases susceptibility.
  • Persistent, refractory thrush without other immunodeficiency signs is rare.

Observation:

  • A patient presented with persistent and refractory oral thrush.
  • Typical clinical signs of oral fungal infection were present.
  • No other signs of immunodeficiency were identified.

Findings:

  • Klinefelter syndrome (47, XXY) was identified as the cause.
  • This represents an unusual etiology for refractory oral candidiasis.
  • Connects a specific genetic condition to recurrent opportunistic infections.

Implications:

  • Suggests genetic factors like Klinefelter syndrome should be considered in unexplained refractory oral thrush.
  • Highlights the need for broader differential diagnoses beyond typical immunodeficiencies.
  • May inform diagnostic approaches for recurrent fungal infections in specific patient populations.