Oral pathogen candida in patients under antineoplastic therapies


  • Martha Rebolledo-Cobos Universidad Metropolitana de Barranquilla. Colombia
  • Marisol Sánchez-Molina Universidad Metropolitana de Barranquilla




neoplasia, cancer, candidiasis, Candida antineoplastic treatment, Candida, antineoplastic treatment, infection


Cancer control treatments are aimed at prolonging patient survival, but they also trigger inevitable and irreversible side effects, often infectious in nature, complicating the prognosis of the oncological disease. These include the pathogenic behavior of Candida, with Albicans being its most common species in the oral mucosa. Albicans is considered a commensal fungus that, as a result of the neutropenia resulting from antineoplastic therapies, behaves as an opportunistic entity causing candidiasis. This fungal infection has aggravating factors for the patient, such as xerostomia and hyposalivation, infections like dental caries, and other factors such as improper oral hygiene. Several consulted authors highlight the presence of Candida, its different species and oral candidiasis as a microorganism and classic opportunistic infection in immunosuppressed patients, and even more in those subjected to antineoplastic treatments. The aim of this review is to describe the pathogenic behavior of Candida in the oral mucosa of patients under antineoplastic treatments.

= 530 veces | PDF
= 354 veces|


Download data is not yet available.

Author Biographies

Martha Rebolledo-Cobos, Universidad Metropolitana de Barranquilla. Colombia

DDS. Stomatologist and Oral Surgeon. MSc in Molecular Genetics. Assistant research professor in Pathology, Semiology, and Oral Surgery, Universidad Metropolitana de Barranquilla.

Marisol Sánchez-Molina, Universidad Metropolitana de Barranquilla

DDS. MSc in Microbiology, Universidad Metropolitana de Barranquilla. Assistant professor in Formative Research, Universidad Metropolitana de Barranquilla


Teoh F, Pavelka N. How chemotherapy increases the risk of systemic candidiasis in cancer patients: current

paradigm and future directions. Pathogens. 2016; 5(1): pii: E6. https://doi.org/10.3390/pathogens5010006

Rodríguez-Leguizamón G, Fiori A, López LF, Gómez BL, Parra-Giraldo CM, Gómez-López A et al.

Characterising atypical Candida albicans clinical isolates from six third-level hospitals in Bogotá, Colombia.

BMC Microbiol. 2015; 15(1): 199. DOI: https://doi.org/10.1186/s12866-015-0535-0

Villanueva Reyes J, Arenas R. Candidiasis mucocutánea. Una revisión. Rev Mex Micol. 2007; 25: 91-104.

De-Sousa LV, Santos VL, de-Souza-Monteiro A, Dias-Souza MV, Marques SG, de-Faria ES et al. Isolation

and identification of Candida species in patients with orogastric cancer: susceptibility to antifungal drugs,

attributes of virulence in vitro and immune response phenotype. BMC Infect Dis. 2016; 23; 16(1): 86.

DOI: https://doi.org/10.1186/s12879-016-1431-4

Yamashita K, Ohara M, Kojima T, Nishimura R, Ogawa T, Hino T et al. Prevalence of drug-resistant

opportunistic microorganisms in oral cavity after treatment for oral cancer. J Oral Sci. 2013; 55(2): 145-55.

Komeno Y, Uryu H, Iwata Y, Hatada Y, Sakamoto J, Iihara K et al. Esophageal candidiasis as the

initial manifestation of acute myeloid leukemia. Intern Med. 2015; 54(23): 3087-92. DOI: https://doi.


Alt-Epping B, Nejad RK, Jung K, Gross U, Nauck F. Symptoms of the oral cavity and their association with

local microbiological and clinical findings—a prospective survey in palliative care. Support Care Cancer.

; 20(3): 531-7. https://doi.org/10.1007/s00520-011-1114-z

Singh A, Verma R, Murari A, Agrawal A. Oral candidiasis: an overview. J Oral Maxillofac Pathol. 2014;

(Suppl 1): S81-5. DOI: https://doi.org/10.4103/0973-029X.141325

Palacios CP, Gómez LM, Cardona N. Candidiasis mucocutánea: espectro clínico. Rev Asoc Colomb

Dermatol. 2011; 19: 239-44.

Del-Palacio A, Villar J, Alhambra A. Epidemiología de las candidiasis invasoras en población pediátrica

y adulta. Rev Iberoam Micol. 2009; 26(1): 1-93. DOI: https://doi.org/10.1016/S1130-1406(09)70002-6

Patil S, Rao RS, Majumdar B, Anil S. Clinical Appearance of Oral Candida Infection and Therapeutic

Strategies. Front Microbiol. 2015; 6: 1391. DOI: https://doi.org/10.3389/fmicb.2015.01391

Kakati B, Kotwal A, Biswas D, Sahu S. Fluconazole Resistant Candida Oesophagitis in Immunocompetent

Patients: Is Empirical Therapy Justifiable? J Clin Diagn Res. 2015; 9(12): DC16-8. DOI: https://doi. org/10.7860/JCDR/2015/15171.6975

Prieto D, Pla J. Distinct stages during colonization of the mouse gastrointestinal tract by

Candida albicans. Front Microbiol. 2015; 6: 792. DOI: https://doi.org/ 10.3389/fmicb.2015.00792

Jung DS, Farmakiotis D, Jiang Y, Tarrand JJ, Kontoyiannis DP. Uncommon Candida Species Fungemia

among Cancer Patients, Houston, Texas, USA. Emerg Infect Dis. 2015; 21(11): 1942-50. DOI: https://doi.


Lim S, Kil TJ, Kim HR, Han S, Rha SY. A case of gingival candidiasis with bone destruction on gastric cancer

patient receiving cytotoxic chemotherapy. Case Rep Oncol Med. 2014; 2014: 145394. DOI: https://doi.


Xu L, Zhang H, Liu J, Chen X. Investigation of the oral infections and manifestations seen in patients with

advanced cancer. Pak J Med Sci. 2013; 29(5): 1112-5.

Gall F, Colella G, Di Onofrio V, Rossiello R, Angelillo IF, Liguori G. Candida spp in oral cancer and oral

precancerous lesions. New Microbiol. 2013; 36(3): 283-8.

Shrestha M, Boaz K, Srikant N, Shakya A. An assessment of Candida colonization and species differentiation

in head and neck cancer patients receiving radiation. J Nepal Health Res Counc. 2014; 12(28): 156-61.

Modrzewska B, Kurnatowski P. Adherence of Candida sp. to host tissues and cells as one of its pathogenicity

features. Ann Parasitol. 2015; 61(1): 3-9.

Galipothu S, Kalawat U, Ram R, Kishore C, Sridhar AV, Chaudhury A et al. Cutaneous fungal infection in a

renal transplantation patient due to a rare fungus belonging to order Pleosporales. Indian J Med Microbiol.

; 33(1): 165-7. https://doi.org/10.4103/0255-0857.148435

Chambô-Filho A, Souza-Filho JB, Pignaton CC, Zon I, Fernandes AS, Cardoso LQ. Chronic mucocutaneous

candidiasis: a case with exuberant cutaneous horns in nipples. An Bras Dermatol. 2014; 89(4): 641-4.

Hirakawa MP, Martinez DA, Sakthikumar S, Anderson MZ, Berlin A, Gujja S et al. Genetic and phenotypic

intra-species variation in Candida albicans. Genome Res. 2015; 25(3): 413-25. DOI: https://doi.


Raz-Pasteur A, Ullmann Y, Berdicevsky I. The pathogenesis of Candida infections in a human skin model:

scanning electron microscope observations. SRN Dermatol. 2011; 2011: 150642. DOI: https://doi.


Laronde DM, Williams PM, Hislop TG, Poh C, Ng S, Zhang L et al. Decision making on detection and

triage of oral mucosa lesions in community dental practices: screening decisions and referral. Community

Dent Oral Epidemiol. 2014; 42(4): 375-84. DOI: https://doi.org/10.1111/cdoe.12093

Roberts CL, Algert CS, Rickard KL, Morris JM. Treatment of vaginal candidiasis for the prevention of

preterm birth: a systematic review and meta-analysis. Syst Rev. 2015; 4: 31. DOI: https://doi.org/10.1186/


Balan P, Gogineni S, Kumari NS, Shetty V, Lakshman-Rangare A, Castelino R et al.


carriage rate

and growth characteristics of saliva in Diabetes Mellitus patients: a case-control study. J Dent Res Dent

Clin Dent Prospects. 2015; 9(4): 274-9. DOI: https://doi.org/10.15171/joddd.2015.048

Kok ET, Jong MC, Gravendeel B, Van-Leeuwen WB, Baars EW. Resistance to antibiotics and antifungal

medicinal products: can complementary and alternative medicine help solve the problem in common

infection diseases? The introduction of a Dutch research consortium. Evid Based Complement Alternat

Med. 2015; 2015: 521584. DOI: https://doi.org/10.1155/2015/521584

Komeno Y, Uryu H, Iwata Y, Hatada Y, Sakamoto J, Iihara K et al. Esophageal candidiasis as the

initial manifestation of acute myeloid leukemia. Intern Med. 2015; 54(23): 3087-92. DOI: https://doi.


Meighani G, Aghamohammadi A, Javanbakht H, Abolhassani H, Nikayin S, Jafari SM et al. Oral and dental

health status in patients with primary antibody deficiencies. Iran J Allergy Asthma Immunol. 2011; 10(4):

-93. DOI: https://doi.org/010.04/ijaai.289293

Lagman R, Davis M, LeGrand S, Walsh D, Parala A, Gamier P, et al. Single-Dose Fluconazole Therapy for

Oral Thrush in Hospice and Palliative Medicine Patients. Am J Hosp Palliat Care. 2017 Aug; 34(7): 645-9.

DOI: 10.1177/1049909116643927

Lara HH, Romero-Urbina DG, Pierce C, Lopez-Ribot JL, Arellano-Jiménez MJ, Jose-Yacaman M. Effect of

silver nanoparticles on Candida albicans biofilms: an ultrastructural study. J Nanobiotechnology. 2015; 13:

DOI: https://doi.org/10.1186/s12951-015-0147-8

Akbari F, Kjellerup BV. Elimination of bloodstream infections associated with Candida albicans

biofilm in intravascular catheters. Pathogens. 2015; 4(3): 457-69. DOI: ttps://doi.org/10.3390/pathogens4030457

Paula SB, Morey AT, Santos JP, Santos PM, Gameiro DG, Kerbauy G et al. Oral Candida colonization in

HIV-infected patients in Londrina-PR, Brazil: antifungal susceptibility and virulence factors. J Infect Dev

Ctries. 2015; 9(12): 1350-9. DOI: https://doi.org/10.3855/jidc.6970

Popova EV, Dermendjieva SI, Vangelova RP. Quantity determination of T- and B-leucocytes in peripheral

blood in patients with Candida induced subprosthetic stomatitis. Folia Med (Plovdiv). 2001; 43(1-2): 50-2.

Garcia-Cuesta C, Sarrion-Pérez MG, Bagán JV. Current treatment of oral candidiasis: A literature review. J

Clin Exp Dent. 2014: 1; 6(5): e576-82. DOI: https://doi.org/10.4317/jced.51798

Thomson DD, Berman J, Brand AC. High frame-rate resolution of cell division during

Candida albicans filamentation. Fungal Genet Biol. 2016; 88: 54-8. https://doi.org/10.1016/j.fgb.2016.02.001

Epstein JB, Thariat J, Bensadoun RJ, Barasch A, Murphy BA, Kolnick L, et al. Oral complications of cancer

and cancer therapy: from cancer treatment to survivorship. CA Cancer J Clin. 2012 Nov-Dec; 62(6): 400-22.

DOI: 10.3322/caac.21157.

Rabagliati R, Fuentes G, Guzmán AM, Orellana E, Oporto J, Aedo I et al. Enfermedad fúngica invasora

en pacientes hemato-oncológicos y receptores de trasplante de precursores hematopoyéticos bajo la

perspectiva de los criterios diagnósticos EORTC/MSG. Rev Chil Infect. 2009; 26(3): 212-9. DOI: http://


Puig-Asensio M, Ruiz-Camps I, Fernández-Ruiz M, Aguado JM, Muñoz P, Valerio M et al. Epidemiology

and outcome of candidaemia in patients with oncological and haematological malignancies: results from

a population-based surveillance in Spain. Clin Microbiol Infect. 2015; 21(5): 491.e1-10. DOI: https://doi.


Shrestha M, Boaz K, Srikant N, Shakya A. An assessment of candidal colonization and species differentiation

in head and neck cancer patients receiving radiation. J Nepal Health Res Counc. 2014; 12(3): 156-61.

Krishnan PA. Fungal infections of the oral mucosa. Indian J Dent Res. 2012; 23(5): 650-9. DOI: https://doi.


Verma SP, Dubashi B, Narayanan P, Basu D, Dutta TK, Dhanraj KM. A case of pediatric acute lymphoblastic

leukemia with invasive candidiasis: short review. Indian J Hematol Blood Transfus. 2014; 30(Suppl 1): 101-

DOI: https://doi.org/10.1007/s12288-013-0274-z

Morais EF, Lira JA, Macedo RA, Santos KS, Elias CT, Morais-Mde L. Oral manifestations resulting from

chemotherapy in children with acute lymphoblastic leukemia. Braz J Otorhinolaryngol. 2014; 80(1): 78-85.

DOI: https://doi.org/10.5935/1808-8694.20140015

Ramla S, Sharma V, Patel M. Influence

of cancer treatment on the Candida albicans isolated from the oral

cavities of cancer patients. Support Care Cancer. 2016; 24(6): 2429-36. DOI: https://doi.org/10.1007/


Ueta E, Tanida T, Yoneda K, Yamamoto T, Osaki T. Increase of Candida cell virulence by anticancer drugs

and irradiation. Oral Microbiol Immunol. 2001; 16(4): 243-9.

Belazi M, Velegraki A, Koussidou-Eremondi T, Andreadis D, Hini S, Arsenis G et al. Oral Candida isolates

in patients undergoing radiotherapy for head and neck cancer: prevalence, azole susceptibility profiles and

response to antifungal treatment. Oral Microbiol Immunol. 2004; 19(6): 347-51.

Cornely O A, Maertens J, Winston D J, Perfect J, Ullman A J, Walsh T J, et al. Posaconazole

vs fluconazole

or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007; 356(4): 348-59. DOI: https://


Siwek GT, Dodgson KJ, de-Magalhaes-Silverman M, Bartelt LA, Kilborn SB, Hoth PL et al. Invasive

zygomycosis in hematopoietic stem cell transplant recipients receiving voriconazole prophylaxis. Clin

Infect Dis. 2004; 39(4): 584-7. DOI: https://doi.org/10.1086/422723

Pizzo PA, Robichaud KJ, Gill FA, Witebsky FG. Empiric antibiotic and antifungal therapy for cancer patients

with prolonged fever and granulocytopenia. Am J Med. 1982; 72(1): 101-11.

Pemán J, Zaragoza R, Quindós G, Alkorta M, Cuétara MS, Camarena JJ et al. Clinical factors associated

with a Candida albicans Germ Tube Antibody positive test in Intensive Care Unit patients. BMC Infect Dis.

; 11: 60. DOI: https://doi.org/10.1186/1471-2334-11-60

Paz M, Kahl S, Escovich L, Garófalo F, Bulacio L, López C. Presencia de hongos levaduriformes en cavidad

oral en pacientes con tratamiento oncológico por cáncer de cabeza y cuello. Caracterización fenotípica.

Estudio piloto. Anuario Fundación Dr. J.R. Villavicencio. 2007; 15: 141-6.

Tosun I, Aydin F, Kaklikkaya N, Erturk M. Induction of secretory aspartyl proteinase of Candida albicans by

HIV-1 but not HSV-2 or some other microorganisms associated with vaginal environment. Mycopathologia.

; 159(2): 213-8. DOI: https://doi.org/10.1007/s11046-004-2226-5

Konopka T, Dembowska E, Pietruska M, Dymalski P, Górska R. Periodontal status and selected parameters

of oral condition of Poles aged 65 to 74 years. Przegl Epidemiol. 2015; 69(3): 537-42.

Sun H, Chen Y, Zou X, Li H, Yin X, Qin H, et al. Occurrence of oral Candida colonization and its risk factors

among patients with malignancies in China. ClinOralInvestig. 2016 Apr; 20(3): 459-67. DOI: 10.1007/


Ramage G, Vandewalle K, Wickes BL, López-Ribot JL. Characteristics of biofilm formation by Candida

albicans. Rev Iberoam Micol. 2001; 18(4): 163-70.

Pulido M, Carmona M, Abud K, Bolivar K, Cortés Y. Presencia de Candida en pacientes con

estomatitis subprotésica que acuden a la facultad de odontología de la Universidad de Cartagena en

el periodo transcurrido entre agosto 2006-junio 2007. Duazary. 2008; 5(2): 90-8. DOI: http://dx.doi.


Rebolledo M, Pastor M. Comportamiento de prótesis dentales removibles como factor causal de

estomatitis subprotésica: Reporte de un caso. Act Odont Col. 2012; 2(2): 105-11. DOI: http://dx.doi.


Li X, Hou Y, Yue L, Liu S, Du J, Sun S. Potential targets for antifungal drug discovery based on growth and

virulence in Candida albicans. Antimicrob Agents Chemother. 2015; 59(10): 5885-91. DOI: https://doi.


Casnati BE, Papone V, Cuestas M, Lorenzo S, Alvarez R, Massa F. Valoración del tratamiento local de la

candidosis oral. Correlación etiológica. Odontoestomatología. 2011; 13(18): 66-75.




How to Cite

Rebolledo-Cobos, M., & Sánchez-Molina, M. (2018). Oral pathogen candida in patients under antineoplastic therapies. Revista Facultad De Odontología Universidad De Antioquia, 30(1), 92–104. https://doi.org/10.17533/udea.rfo.v30n1a9

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.