title: Pseudomembranous candidosis in nephrotic syndrome: a case report.
abstract: A 33-year-old male presented for evaluation of several large, recently discovered white oral lesions of unknown duration. Clinical examination revealed multiple white plaques on the soft palate, uvula, buccal mucosa, and tongue. These lesions could be wiped away, leaving an erythematous base. The lesions were asymptomatic, and the patient did not report difficulty in swallowing. The patient's medical history was noteworthy for several significant diagnoses within the previous 6 months: type 2 diabetes mellitus, mild systolic hypertension, gastroesophageal reflux disease, and adult idiopathic nephrotic syndrome, determined by kidney biopsy to be caused by focal segmental glomerulosclerosis. A provisional diagnosis of pseudomembraneous candidosis was made, and the patient responded to a 14-day course of clotrimazole, administered in 10-mg troches, five times a day. Management of nephrotic syndrome predisposes patients to recurrent fungal infections, and the disease has implications for the selection of systemic antifungal agents.
authors.affiliation: Naval Dental Center, Marine Corps Recruiting Depot, Parris Island, South Carolina, USA.
authors.forename: Leo
authors.initials: L
authors.lastname: Prusinski
authors.forename: Robert G
authors.initials: RG
authors.lastname: Sherman
authors.forename: Michele Carter
authors.initials: MC
authors.lastname: Ravenel
authors.forename: Richard A
authors.initials: RA
authors.lastname: Joralmon
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002180:Candidiasis, Oral / Q000175:diagnosis*; D003022:Clotrimazole / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005764:Gastroesophageal Reflux / Q000150:complications; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009061:Mouth Mucosa / Q000382:microbiology; D009404:Nephrotic Syndrome / Q000150:complications*; D010160:Palate, Soft / Q000382:microbiology; D014060:Tongue Diseases / Q000382:microbiology; D014609:Uvula / Q000382:microbiology
chemical_list: D000935:Antifungal Agents; D003022:Clotrimazole