Candidiasis may induce glossodynia without objective manifestation.
BACKGROUND
The causes of glossodynia in the absence of objective abnormalities range widely and differential diagnosis of glossodynia is very difficult.


METHODS
Based on the examination results of peripheral blood, stimulated and nonstimulated salivary flow rate (SFR), glossal pain threshold, and C. albicans cell culture and the response to treatment, we identified the cause of vague pain of the tongue in 98 patients who lacked objective findings and identified candidiasis as the cause of glossodynia in 26 patients.


RESULTS
These patients revealed hyposalivation and decreased glossal pain thresholds and C. albicans cell overgrowth. Pain thresholds in the painful portion (54.6+/-2.9 degrees C) were significantly decreased compared with those in the painless portion (57.7+/-3.4 degrees C) (P < 0.05) and the pain thresholds were largely increased after treatment (57.2+/-1.6 degrees C). Nonstimulated SFR before treatment was lower than that of age- and gender-matched healthy people, although stimulated SFR was decreased only slightly. C. albicans cell overgrowth was detected by the number of C. albicans colonies that formed in Sabouraud's agar plate (539.3+/-198.4/dish). After the subsidence of glossal pain by mouth washing with a 3% amphotericin B solution, the C. albicans colonies were decreased to 31.5+/-19.3/dish, which was almost same as the control level, 14.1+/-8.4/dish.


CONCLUSIONS
These results indicate that candidiasis in conjunction with hyposalivation may induce pain in the tongue without manifestation of objective abnormalities.
Osaki
T
T
Department of Oral Surgery, Kochi Medical School, Nankoku-city, Japan.
Yoneda
K
K
Yamamoto
T
T
Ueta
E
E
Kimura
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002177:Candidiasis / Q000150:complications* / Q000175:diagnosis*; D003663:Decision Trees; D003937:Diagnosis, Differential; D005260:Female; D005926:Glossalgia / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold; D012472:Salivation