amphotericin-b and Dental-Caries

Microbiological analyses of saliva and swabs were obtained from carious lesions of 54 children and adolescents with carious teeth, and of 49 boys and girls with healthy teeth. Candida species were isolated from the saliva of 36 (66.7%) subjects with active caries, but from the saliva of only one (2%) of the 49 caries-free subjects. Candida was detected in material removed from the carious lesion in 44 (81.5%) of the children with caries. Thirty patients with carious teeth and colonized by Candida were randomly divided into three groups of 10 individuals each, and either treated by complete dental restoration, by local application of amphotericin B or by a combination of dental treatment plus amphotericin B. The final microbiological control showed that thorough dental treatment alone eliminated fungi from the oral cavity in 90% of cases, whereas the local application of amphotericin B alone had a minimal effect on the candidal colonization of carious lesions. When, in addition to dental treatment, amphotericin B was applied, fungi were completely eliminated from the oral cavity of all subjects.

Topics: Adolescent; Amphotericin B; Antifungal Agents; Candida; Child; Child, Preschool; Dental Caries; Dental Restoration, Permanent; Female; Humans; Male; Saliva

Hyposalivation is a long-term effect in patients receiving head and neck radiation. Radiotherapy can predispose oral colonization by Candida species of the mucosa. This study aims to evaluate the correlation between hyposalivation, measured by unstimulated saliva flow rates (SFR) and fungal colonization of the oral cavity, and also the resistance of isolated Candida strains to antimicrobial therapy. Fifty-three consecutive patients with radiotherapy were examined for late radiation damage on dental hard tissue and the salivary glands (SFR over a period of 5 min). The SFR were divided into three different values of hyposalivation: grade I (SFR 0.1-0.25 ml/min), grade II (SFR ≤0.1 ml/min), and grade III (SFR = 0.0 ml/min). Candidal colonization was defined using Sabouraud agar and identified using API 20C AUX (biomerieux) in the patients' rinsing water. Susceptibility was tested with Etest (amphotericin B, ketoconacole, voriconacole, and fluconacole). Hyposalivation grade I was detected in 23% (9.1 × 10(1) colony forming units (cfu); range, 200-5,900 cfu), hyposalivation grade II in 26% (4.3 × 10(1) cfu; range, 110-3,300 cfu), and hyposalivation grade III in 51% (2.0 × 10(3) cfu; range, 300-19,475 cfu) of patients. A significant correlation between the SFR and candidal colonization and clinical presentation (European Organization for Research and Treatment of Cancer (EORTC) score) was detected (Mann-Whitney test, p = 0.031). Twenty Candida albicans and 27 non-albicans species were identified. The resistance of C. albicans was higher than that of non-albicans strains against antimicrobial agents. By comparison, amphotericin B showed the greatest and fluconazole the least effect. A higher value of hyposalivation correlates with a higher risk of candidal colonization in patients who have received radiotherapy and also with a higher EORTC score. The spectrum of Candida is wide and susceptibility against antifungal therapy differs. In long-term examinations of patients with xerostomia after radiotherapy, the EORTC score can be used to measure hyposalivation. Reduced susceptibility of C. albicans might introduce complications to therapy. Findings of more non-albicans strains show a change in colonization which should be examined in further studies.

Topics: Adult; Aged; Aged, 80 and over; Amphotericin B; Antifungal Agents; Candida; Candida albicans; Colony Count, Microbial; Dental Caries; Drug Resistance, Fungal; Female; Fluconazole; Head and Neck Neoplasms; Humans; Ketoconazole; Male; Microbial Sensitivity Tests; Middle Aged; Mouth; Pyrimidines; Radiation Injuries; Saliva; Salivary Glands; Secretory Rate; Triazoles; Voriconazole; Xerostomia

Reports in the literature of patients surviving mucormycosis involving the craniofacial structures are exceedingly rare. The necessity for early diagnosis by recognition of any of the six key signs and symptoms is emphasized. The futility of standard diagnostic tools, other than biopsy, is noted. An underlying debilitating condition such as diabetic ketoacidosis can predispose the patient to an acute infection by this usually nonpathogenic organism. The requirement for prompt treatment of the debilitating condition together with treatment to eradicate the fungus is stressed.

Topics: Abscess; Adult; Amphotericin B; Cavernous Sinus; Cranial Nerves; Dental Caries; Diabetes Complications; Diabetic Coma; Diabetic Neuropathies; Diagnosis, Differential; Face; Humans; Insulin; Lung Diseases; Male; Mucormycosis; Ophthalmoplegia; Pneumonia; Sinus Thrombosis, Intracranial; Skull; Tooth Diseases; Urinary Tract Infections

Topics: Adult; Agar; Amphotericin B; Culture Media; Dental Caries; Humans; Lacticaseibacillus casei; Lactobacillus; Lactobacillus acidophilus; Yeasts