Oral candidiasis in children and adolescents with cancers – Identification of Candida species H. Gonzalez, E. Gonzalez, O. Zambrano, M. Lozano, S. Rodriguez, S. Robertis, L. Mesa
Medicina Oral Patologia Oral y Cirugía Bucal 2007: 12 Supl 5: 287–292 The objective of this study was to identify the presence of Candida species in oral lesions of children with different types of oncologic diseases.
110 patients treated with cytostatic therapy due to neoplastic diseases were included in a cross-sectional study at the Department of Paediatric Oncology, University of Maracaibo (Venezuela) between February and May 2003. Age ranged between 0 and 16 years. 62 patients were found presenting lesions on the oral mucosa consistent with candidiasis. Patients with previous antifungal therapy, calculus, extensive caries or intraoral appliances were excluded. After clinical evaluation, samples were taken in every case and studied with direct examination and culture in CHROM agar-candida and Sabouraud Dextrose agar with Chloramphenicol during 7 days. The identification of the isolated microorganism was performed by the filamentation test, carbohydrate fermentation and assimilation. Statistical methods included descriptive analysis, Chi square and Fisher tests.
43 out of 62 patients (69.3%) showed positive findings of oral candidiasis. Concerning age, the group of children between 7 and 12 years showed the highest rate of oral candidiasis (20 out of 23 cases), followed by patients from 0 to 2 years old (6 out of 8 cases). Although differences were not statistically significant, Candida albicans was the most frequent species found (20 cases, 42.55%), followed by Candida parapsilosis (14.89%), C. tropicalis (12.77%), C. krusei (4.26%), C. glabrata (2.13%) and C. lusitaniae ((2.13%). In 93% of cases, more than one species were isolated. Location of the lesions was on the tongue in 72.7% of cases. Buccal mucosa was the second location (12.7%), followed by the soft palate (10.9%) and the lips. The pseudomembranous candidiasis was the most frequent clinical presentation (78.71%). According to the type of oncologic diseases, patients affected by acute lymphoid leukaemia showed the highest rate of oral candidiasis although statistical analysis did not show any significant differences on sex and age of patients, types of neoplastic disease or cytostatic agents used in the treatment.
The authors concluded that oral candidiasis is a frequent complication in the paediatric oncologic patients. Candida albicans is the main aetiological agent, however other species are also frequently isolated.