Two cases of human immunodeficiency virus infection in patients with oral candidiasis

Abstract

Oral candidiasis is one of the most common oral opportunistic infections seen in association with human immunodeficiency virus (HIV) infection and is considered the initial manifestation of HIV. We herein report two patients with non-pseudomembranous candidiasis that proved to be the first indicator of HIV infection. Case 1 was a 69-year-old male. An oral examination revealed erythematous mucosa and atrophy of the lingual papillae of the tongue, which was diagnosed as mycosis. He had frequently traveled to Thailand. An HIV antibody test was positive. Case 2 was a 44-year-old male. An oral examination revealed atrophic findings on the tongue and a small ulcerative lesion at the midline of the tongue. A biopsy revealed oral candidiasis, and a diagnosis of midline rhomboid glossitis due to Candida was made. An interview revealed that he was a homosexual, and an HIV antibody test was positive. Oral candidiasis can be the initial indicator of underlying HIV infection. An early diagnosis/intervention with HIV treatment is important for improving the prognosis and preventing spread of the infection. Thus, otolaryngologists, who make many oral observations, should be aware of the characteristics and presentation of erythematous and hyperplastic candidiasis as early marker for HIV infection, especially in patients with no other immunosuppressive status.