Departement of Oral Medicine, Universitas Islam Sultan Agung - Indonesia
Management Of Oral Candidiasis Children And Infant With Hiv/Aids Infection : Report Of Two Cases
Rina Kartika Sari
Alrevo Panji Auradewa
Salma Qatrunnada Sayuti
(*) Corresponding Author
Background: HIV infection is characterized by progressive immunosuppression due to low absolute CD4 counts. The most common HIV-related oral disorder is oral candidiasis.
Case(s): First case, A 10-month-old baby girl complained of white plaque on her hard palate since 3 months ago.She had experienced the same before and was treated with Nystatin then the lesion resolved. She was HIV positive and took Abacavir twice a day. The latest CD4 test was 3 months ago and the result was 1000 cells/µL. The second case is an 8-year-old male patient who complained white lesion all over his mouth one week ago and treated by Nystatin for 7 days but the lesion has not resolved. He had confirmed HIV at 2.5 y.o and takes ARV regularly. The CD4 count three weeks ago was 8 cells/mm3. Both of them were diagnosed with acute pseudomembranous candidiasis
Management: The first patient was given Nystatin oral suspension 4 times a day and the lesion resolved in 1 week. The caregiver instructed to clean the child's mouth with gauze regularly. The second patient was given fluconazole 150 mg tablets 3-6 mg/kg once a day for 14 days. Both of the lesions responded well to antifungal.
Conclusion: Oral candidiasis in children with HIV often occurs in conditions of low CD4 and often appears as acute pseudomembranous candidiasis. Treatment of is adjusted to the PNPK HIV Kemenkes RI 2019 according to the level of disease
Case(s): First case, A 10-month-old baby girl complained of white plaque on her hard palate since 3 months ago.She had experienced the same before and was treated with Nystatin then the lesion resolved. She was HIV positive and took Abacavir twice a day. The latest CD4 test was 3 months ago and the result was 1000 cells/µL. The second case is an 8-year-old male patient who complained white lesion all over his mouth one week ago and treated by Nystatin for 7 days but the lesion has not resolved. He had confirmed HIV at 2.5 y.o and takes ARV regularly. The CD4 count three weeks ago was 8 cells/mm3. Both of them were diagnosed with acute pseudomembranous candidiasis
Management: The first patient was given Nystatin oral suspension 4 times a day and the lesion resolved in 1 week. The caregiver instructed to clean the child's mouth with gauze regularly. The second patient was given fluconazole 150 mg tablets 3-6 mg/kg once a day for 14 days. Both of the lesions responded well to antifungal.
Conclusion: Oral candidiasis in children with HIV often occurs in conditions of low CD4 and often appears as acute pseudomembranous candidiasis. Treatment of is adjusted to the PNPK HIV Kemenkes RI 2019 according to the level of disease
Keywords: Oral Candidiasis;HIV/AIDS;Children
- Mohapatra A, Sahoo D. Review on HIV AIDS. Int J Psychosoc Rehabil. 2019;23(6):521–7.
- Lauritano D, Moreo G, Oberti L, Lucchese A, Di Stasio D, Conese M, et al. Oral manifestations in HIV-positive children: A systematic review. Pathogens. 2020;9(2):1–15.
- Li Z, Purcell DW, Sansom SL, Hayes D, Hall HI. Vital Signs: HIV Transmission Along the Continuum of Care — United States, 2016 . MMWR Morb Mortal Wkly Rep. 2019;68(11):267–72.
- Kemenkes RI. KEPUTUSAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR HK.01.07/MENKES/90/2019 TENTANG PEDOMAN NASIONAL PELAYANAN KEDOKTERAN TATA LAKSANA HIV. 2019;
- Direktur Jenderal P2P. Laporan Perkembangan HIV AIDS & Penyakit lnfeksi Menular Seksual (PIMS) Triwulan I Tahun 2021. Kementeri Kesehat RI [Internet]. 2021;4247608(021):613–4. Available from: https://siha.kemkes.go.id/portal/perkembangan-kasus-hiv-aids_pims#
- Sachdeva S, Dutta S, Sabir H, Sachdeva A. Oral Thrush in an infant: A case report with treatment modalities. Pediatr Dent Care [Internet]. 2016;1(2):107–8. Available from: http://dx.doi.org/10.4172/pdc.1000107
- Usman NA, Prasetyaningtyas N, Endah A, Hendarti HT, Soebadi B. Kandidiasis oral sebagai penanda infeksi HIV/AIDS: laporan kasus. Makassar Dent J. 2017;6(2):50–8.
- Mensana MP, Ernawati DS, Nugraha AP, et al. Oral candidiasis profile of the Indonesian HIV-infected pediatric patients at UPIPI Dr . Soetomo General Hospital , Surabaya , Indonesia. 2018;17(4).
- Lestari PE. Infeksi Jamur Candida pada Penderita HIV/AIDS. Stomatogantic. 2013;10:35–8.
- Rafika M, Dewi T. Oral opportunistic infections in patient with HIV wasting syndrome. Sci Dent J. 2019;3(1):31.
- Triwardhani L, Dewi SRP. Acute Pseudomembranous Candidiasis in Patients with Hypertension. Sriwij J Dent. 2020;1(1):43–51.
- Thabusum A. Pediatric Oral Manifestations of HIV- A Case Report with Review. 2019;7(April):1038–41.
- Mensana MP, Nugraha AP, Ernawati DS, et al. Sensitivity and specificity of linear gingival erythema as immune suppression marker in pediatric HIV-infected at UPIPI Soetomo general hospital Surabaya, Indonesia. Indian J Public Heal Res Dev. 2019;10(2):572-577. doi:10.5958/0976-5506.2019.00353.X
- Masuku WDM, Angriany D, Winias S, Parmadiati AE. Penanganan kandidiasis orofaring pada pasien Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome ( HIV / AIDS ) dengan nilai CD4 dibawah 10 sel / µL : laporan kasus. Intisari Sains Medis. 2021;12(2):627–34.
- Vainionpää A. Neonatal thrush of newborns : Oral candidiasis ? 2019;(May):580-582. doi:10.1002/cre2.213
- Khaleefa RH, Ahmed LT, Hameed DS. Oral and Dermal Candidiasis Among Infants in Al-Battol Teaching Hospital. 2020;19(2):147-156.
