Oropharyngeal candidiasis: Diagnostic clues, treatment tips

The most common manifestation of oropharyngeal candidiasis (OPC) is pseudomembranous candidiasis, commonly known as "thrush," which appears as a whitish yellow, curdlike discharge on the mucosal surfaces. Other forms of OPC include denture stomatitis, angular cheilitis, and glossitis. Patients with denture stomatitis are usually asymptomatic, but the tissue beneath the denture is typically red and hyperplastic. Patients with angular cheilitis may complain of a burning sensation at the margins of the lips. Candidiasis involving the tongue can be exuberant and is usually associated with complaints of a white tongue, taste alterations, and a burning sensation of the tongue. The diagnosis of OPC can be established by identifying typical fungal elements on potassium hydroxide preparation or Gram stain of scraped material. Treatment options include clotrimazole, fluconazole, itraconazole, and nystatin.