Oral Candidiasis in Immunocompromised Populations

Oral candidiasis is a common opportunistic infection characterised by overgrowth of Candida species on the mucosal surfaces of the mouth. In individuals with weakened immune systems—such as those undergoing chemotherapy, radiotherapy for head and neck malignancies, haematopoietic stem cell transplantation or living with HIV/AIDS—the balance between host defences and fungal colonisation is perturbed, allowing pathogenic Candida to proliferate. Candida albicans remains the predominant causative agent owing to its capacity for yeast-to-hypha transition, biofilm formation and secretion of hydrolytic enzymes. Non-albicans Candida species—including C. glabrata, C. tropicalis and C. krusei—are increasingly implicated, presenting challenges associated with resistance to azole and echinocandin antifungals. Clinical presentations range from pseudomembranous and erythematous lesions to angular cheilitis and hyperplastic candidosis; in severe cases, mucosal barrier breach may give rise to systemic dissemination. Management hinges on accurate diagnosis, addressing predisposing factors such as xerostomia, poor oral hygiene and denture use, and deploying topical or systemic antifungal agents guided by susceptibility profiles. Emerging research emphasises the need for rapid identification techniques, novel therapeutics and integrative preventive strategies to reduce morbidity and improve quality of life in vulnerable patient cohorts worldwide.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Oral Candidiasis in Immunocompromised Populations publication trend

The graph below shows the total number of articles in oral candidiasis in immunocompromised populations across all publications each year (not limited to Nature Index journals).

Technical terms

Immunocompromised host: An individual whose immune response is impaired by disease, medical treatment or genetic conditions, increasing susceptibility to opportunistic infections.

Non-albicans Candida: Candida species other than C. albicans, often associated with higher intrinsic resistance to common antifungal agents.

Antifungal susceptibility: The responsiveness of a fungal isolate to antifungal drugs, determined by in vitro testing to guide therapeutic choices.

Biofilm: A structured community of microbial cells encased in an extracellular matrix, adherent to surfaces and exhibiting increased resistance to antifungal treatment.

MALDI-TOF MS: A rapid mass spectrometry technique used to identify microbial species based on protein fingerprinting, facilitating timely diagnosis and management.

References

1. A 3-year study of Candida infections among patients with malignancy: etiologic agents and antifungal susceptibility profile. Frontiers in Cellular and Infection Microbiology (2023).
2. Antimicrobial Activity of Olive Leaf Extract to Oral Candida Isolates. Microorganisms (2024).
3. Mycobiota profile of oral fungal infections in head and neck cancer patients receiving radiotherapy: A 6-year retrospective MALDI-TOF mass spectrometry study. Oral Oncology (2023).