Nutrition and Oral Medicine (Nutrition and Health)

230Table 2Fungal InfectionsOral Clinical Differential NutritionalManifestations Presentation Diagnosis Treatment Significance Marker for HIV ImplicationsPseudomembranous White or yellowish, Nystatin oral pastille, one to CD4 cells below 400 Not generally, In severe cases, eatingcandidiasis single or confluent two pastilles dissolved slowly cells/mm 3 indicates early and swallowing can beplaques; easily rubbed four to five times a day; clotri- immune uncomfortableoff; any surface mazole oral troche 10 mg, suppression1 troche dissolved five timesa day; nystatin oral suspension;fluconazole one to two100 mg tablets QD; ketoconazoleone to two 200 mg tabletsQD taken with food; itraconazoletwo 100 mg capsules QDErythematous Red or atrophic Same as pseudomembranous Any stage of HIV Not generally, Longstanding lesionscandidiasis patches on any surface, candidiasis indicates early may produce a burninghowever, greater on the immune sensationtongue and hard palatesuppressionHyperplastic White or discolored Leukoplakia, Fluconazole, one to two CD4 cell count below Yes, severe Burning sensation and acandidiasis plaques; solitary or OHL 100 mg tablets QD; ketocon- 100 cells per mm 3 ; immune feeling of having a “largeconfluent; cannot be azole one to two 200 mg high predilection for suppression ball of cotton in therubbed or wiped off tablets QD taken with food; either having or devel- mouth”; xerostomia;itraconazole two 100 mg oping esophageal eating and swallowingcapsules QD candidiasis may be uncomfortableAngular chelitis Radiating red fissures; Ketoconazole ointment 2%; No Difficulty opening thecommissures of the lips apply to affected areas four mouth because of paintimes a day for 14 d;miconazole ointment 2%;apply to affected areas fourtimes a day for 14 dHistoplasmosis Ulcerations to Amphotericin B; Severe immune Yes Advanced stages,granulomas ketoconazole; itraconazole suppression difficulty eating230 Part IV / Select Diseases and Conditions