Dian Angriany, Hendri Susanto, Adiastuti Endah, Bagus Soebadi
Airlangga University, Surabaya, Indonesia
Introduction: Oral candidiasis is a commonly found opportunistic infection in HIV/AIDS patient. Neoplasms may also frequently be found in the oral cavity of HIV/AIDS patient and may be indicative of the progression of HIV infection.
Case: A 56-year-old male driver came to the Oral Medicine Clinic at the Dental Hospital,Airlangga University. He complained of having tightness in the chest for the previous two months and had difficulty eating and swallowing. Various medications were prescribed to relieve the complaints but there was no improvement. He suffered a weight loss of 10 kg in the preceding three months and had an earlier history of surgery to his scalp due to a car accident several years ago. On physical examination he was found to be pale and weak. Intraorally, diffuse pseudomembranous plaques were found throughout the oral cavity to the pharynx. An exophytic mass of red colour was visible in the palate area extending to oropharynx. Direct mycology tests for oral lesions, a full blood count and an HIV rapid test were conducted. Topical antifungal (Nystatin) was prescribed after the direct mycology test result was positive for Candida albicans, a reactive anti-HIV examination with immunochromatography confirmed the patients was HIV positive and a referral was made to the head and neck oncology surgery clinic in Dr. Soetomo hospital for diagnosis of the palatal enlargement . Unfortunately, the patient dies after the second visit.
Discussion: Based on the subjective and clinical examination, this patient was HIV seropositive and appeared to be suffering with acute pseudomembranous candidiasis accompanied by unconfirmed oral Kaposi's sarcoma. Late management of the oral candidiasis and oral malignant lesion, suggested a poor prognosis for the future treatment of the patient.
Conclusion: Oral candidiasis may be accompanied by malignant oral lesions in patients living with HIV/AIDS. A multidisciplinary approach was needed to manage concurrent oral candidiasis and oral malignancy in HIV/AIDS patient.
Key words: oral candidiasis, oral malignant lesions, Candida albicans, HIV/AIDS