Clinical Characteristics and Relevance of Oral Candida Biofilm in Tongue Smears

• Published in: Journal of fungi (Basel) Vol. 7; no. 2; p. 77
• Main Authors: Cho, Eunae, Park, YounJung, Kim, Ki-Yeol, Han, Dawool, Kim, Hyun Sil, Kwon, Jeong-Seung, Ahn, Hyung-Joon
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 22.01.2021; MDPI
• Subjects: atrophic candidiasis; Atrophy; biofilm; Biofilms; Blood; Candida; Candidiasis; Datasets; erythematous candidiasis; Hyphae; Infections; Medical records; Morphology; Nutrient deficiency; oral candidiasis; Oral cavity; Pain; Risk factors; Tongue; atrophic candidiasis; tongue; Candida; erythematous candidiasis; biofilm; oral candidiasis; hyphae; smears
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof7020077

Dimorphic exist as commensal yeast carriages or infiltrate hyphae in the oral cavity. Here, we investigated the clinical relevance of hyphae in non-pseudomembranous oral candidiasis (OC) by smears of tongue biofilms. We conducted a retrospective study of 2829 patients who had had tongue smears regardless of OC suspicion. Clinical characteristics were evaluated using a novel method of assessing hyphae. Clinical factors (moderate/severe stimulated pain, pain aggravated by stimulation, tongue dorsum appearance and initial topical antifungal use) were highly significant in the high-grade hyphae group but were statistically similar in the low-grade hyphae and non-observed hyphae group, suggesting low-grade hyphae infection as a subclinical OC state. In addition to erythematous candidiasis (EC), a new subtype named "morphologically normal symptomatic candidiasis" (MNSC) with specific pain patterns and normal tongue morphology was identified. MNSC had a significantly higher proportion of moderate and severe stimulated pain cases than EC. Low unstimulated salivary flow rate (<0.1 mL/min) was found to be a common risk factor in MNSC and EC. In non-pseudomembranous OC, pain patterns were dependent on hyphae degree regardless of tongue dorsum morphology. Morphologic differences seen in high-grade hyphae infection were not associated with systemic diseases or nutritional deficiencies.