Oral Manifestations Of HIV

Oral manifestations in AIDS
  • Thrush – candida infection
  • Hairy leukoplakia – EBV infection
  • Aphthous ulcers Mucocutaneous Herpes simplex
CANDIDIASIS:
  •  Classification: Traditional classification of oral candidiasis:
  1. Acute candidiasis: pseudomembranous candidiasis (oral thrush)
  2. atrophic candidiasis
  • Chronic candidiasis:
  1. atrophic candidiasis
  2. hyperplastic candidiasis
  • chronic oral candidiasis (Candida leukoplakia)
  • candidiasis endocrinopathy syndrome
  • chronic localized mucocutaneous candidiasis
  • chronic diffuse candidiasis.
Signs and symptoms: 
  • Most types of oral candidiasis are painless, but a burning sensation may occur in some cases more likely with erythematous (atrophic) candidiasis, whilst hyperplastic candidiasis is normally entirely asymptomatic
  • White plaque-like material commonly involving tongue and buccal mucosa,
  • Candidiasis can therefore sometimes be misdiagnosed as burning mouth syndrome. 
  • Acute atrophic candidiasis may feel like the mouth has been scalded with a hot liquid
  • Another potential symptom is a metallic, acidic, salty or bitter taste in the mouth.
  • The pseudomembranous type rarely causes any symptoms apart from possibly some discomfort or bad taste due to the presence of the membranes.
  • Sometimes the patient describes the raised pseudomembranes as "blisters."
  • Occasionally there can be dysphagia (difficulty swallowing), which indicates that the candidiasis involves the oropharynx or the esophagus,as well as the mouth.
  • The trachea and the larynx may also be involved where there is oral candidiasis, and this may cause hoarseness of the voice.
  • Laboratory findings show growth in cornmeal agar at 20 degree celcius, microscopy showing hyphae and growth in human serum at 37 degree celcius show budding yeasts.
ORAL HAIRY LEUKOPLAKIA:
  • Hairy leukoplakia (also known as oral hairy leukoplakia,OHL, or HIV-associated hairy leukoplakia),is a white patch on the side of the tongue with a corrugated or hairy appearance. Oral hairy leukoplakia is virtually pathognomic of HIV disease in the context of HIV risk factors.
  • It is caused by Epstein-Barr virus (EBV) and occurs usually in persons who are immunocompromised, especially those with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). 
  • This white lesion cannot be scraped off. The lesion itself is benign and does not require any treatment, although its appearance may have diagnostic and prognostic implications for the underlying condition.
Signs and symptoms:
  • There are no symptoms associated with the lesion itself, although many and varied symptoms and signs may be associated with the underlying cause of immunosuppression. The lesion is a white patch, which almost exclusively occurs on the lateral surfaces of the tongue, although rarely it may occur on the buccal mucosa, soft palate, pharynx or esophagus. 
  • The lesion may grow to involve the dorsal surface of the tongue. The texture is vertically corrugated ("hairy") or thickly furrowed and shaggy in appearance
Exam Question
  • In HIV patients White plaque-like material commonly involving tongue and buccal mucosa, with Occasional dysphagia (difficulty swallowing),involves the oropharynx or the esophagus,as well as the mouth is seen in oral candidiasis 
  • Laboratory findings in candida albicans show growth in cornmeal agar at 20 degree celcius, microscopy showing hyphae and growth in human serum at 37 degree celcius show budding yeasts. 
  • Oral hairy leukoplakia is virtually pathognomic of HIV disease in the context of HIV risk factors.
  • Mnemonics

Don't Forget to Solve all the previous Year Question asked on Oral Manifestations Of HIV