Incidence of Oral Candida in Children under corticosteroid therapy and the use of chlorhexidine mouth wash as a preventive measure

ABSTRACT

In this study 60 children indicated for corticosteroid therapy were classified according to the mouth wash into Group [I] Chlorhexidine 0.2% mouth wash [30 cases] Group [II] Saline mouth wash [30 cases]. Further subdivision was done according to mode of corticosteroid administration; 20 cases in each group under systemic therapy while 10 cases in each group under inhaled therapy. Cases were examined clinically for signs and symptoms of oral candidiasis. Microbiological examination included mucosal smear, culture, viable candidal count and identification of Candida albicans by germ tube and morphology on cornmeal tween 80.There is one case under systemic steroid therapy and using chlorhexidine mouth wash that developed clinical signs and symptoms of candidiasis compared to two cases under the same therapy but using saline as a mouth wash. No manifestations found in cases under inhaled steroid therapy either using chlorhexidine or saline. There was no increase of positive culture in patients under inhaled therapy using chlorhexidine or chlorhexidine or saline. While in patients under systemic steroid it increased to reach 65% with chlorhexidine and 85% with saline mouth wash. Incidence of Candida albicans infection was high [ranged from 75-100% of positive cultures] compared with other Candida species [0-25%]. There is an increase in the incidence of carrier and diseased patients according to the viable candidal count ranging from 10% to 45%