Evaluation of Candidiasis in Upper-Aerodigestive Squamous Cell Carcinoma Patients—A Clinico-Mycological Aspect

Abstract

Candida is a commensal yeast. It can be infective when the host’s defense mechanism is weakened, as in the case of squamous cell carcinoma patients. We aimed to evaluate the prevalence and clinical mycological manifestation of candidiasis in 150 cancer cases comprised of preoperative and post-operative (with or without radiotherapy) upper aerodigestive squamous cell carcinoma. A total of 150 patients suffering from squamous cell carcinoma of the Upper Aero-Digestive Tract (UADT) were divided into preoperative (n = 48), post-operative without radiotherapy (n = 29) and post-operative with radiotherapy (n = 73). Samples were collected using cotton swabs and cultured. Candida species were identified according to color pigmentation on Candida Differential Agar (CDA) plate. The clinico-mycological association of patients was evaluated by the chi-square test, and 98 out of 150 patients showed the presence of various Candida species. The major species isolated was Candida albicans (53%), followed by Candida tropicalis (16%). There was a significant statistical difference between patients who showed mycological associations and patients who did not have any such association (p = 0.0008). The prevalence of oral candidiasis was found to be 65.33% among total cases of upper aero-digestive squamous cell carcinoma. Chronic erythematous cases of candidiasis were mainly seen in preoperative squamous cell carcinoma cases, whereas the acute erythematous type of candidiasis was mainly seen in post-operative cases who received radiotherapy. The clinicomycological assessment can help to correlate the signs and symptoms with the presence of candidiasis in upper aerodigestive squamous cell carcinoma patients. Meticulous testing and examination can help in the early detection of candidiasis. Future studies are needed to develop advance scientific preventive strategies for high-risk cases.

Personalized Medicine in Oral Oncology: Imaging Methods and Biological Markers to Support Diagnosis of Oral Squamous Cell Carcinoma (OSCC): A Narrative Literature Review

“…Moreover, chronic oral infections, such as oral candidiasis and those sustaining periodontitis, also have been recognized as high-risk factors associated with the development of OSCC [ 15 , 60 , 64 , 203 , 204 , 205 , 206 ].…”

“…The microbiota of the oral cavity changes by age, sex, and lifestyle [ 49 , 50 , 51 ] and varies according to local and systemic factors [ 52 , 53 , 54 ] and diseases [ 54 , 55 , 56 , 57 ]. Lastly, the role of chronic fungal superinfections is responsible for the detrimental conditions of oncologic patients, thus being a relevant risk factor for OSCC-related morbidity as well a risk factor for cancerogenesis itself [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ].…”

Natural Compounds with Antimicrobial Activities in Oral Candida Infections during Head and Neck Radiotherapy

“…Around 65 % of patients treated with radiotherapy were found positive for oral candidiasis at the Institute of Medical Sciences (IMS) and SUM Hospital, Odisha, India. Several Candida species were detected from the oral swab collected: C. albicans, C. tropicalis, C. glabrata, C. krusei, C. parapsilosis, C. dubliniensis [31].…”