Tests
1st tests to order
superficial smear of lesion for microscopy
Test
The surface of the lesion is, rather forcefully, scraped with a swab or a sterile tongue blade, smeared on a glass slide, and fixed with a fixative spray.
A potassium hydroxide wet mount may be prepared or periodic acid-Schiff staining applied and the smear evaluated.
Negative result may indicate poor technique, low levels of superficial yeast hyphae in the lesion, or no infection.
If inadequate sample is obtained, the test is repeated.
In erythematous candidiasis the level of fungal hyphae is low and may not yield a positive smear.
In this case, empiric antifungal treatment may be commenced or a biopsy sample of the lesion may be taken for definitive diagnosis.
Result
results indicate positive for Candida hyphae
Tests to consider
biopsy of lesion
Test
May be performed subsequently, after superficial smear analysis, for definitive diagnosis.
Result
Candida hyphae, extending into the spinous cell layer of the epithelium, with marked parakeratosis, acanthosis, and spongiosis, as well as a submucosal neutrophil response
culture of mouth rinse sample
Test
Not usually indicated for cases of oral candidiasis where diagnosis is possible by clinical presentation or by smear exam.
May be used to determine whether antifungal prophylaxis is indicated in a patient who would not typically be considered for prophylaxis.
Patient rinses with 10 mL of saline for 1 minute and expectorates in a sterile container, and sample is sent for culture in Sabouraud or chrome agar medium.
Result
approximately ≥400 colony-forming units/mL
upper GI endoscopy with or without biopsy of lesions
Test
Performed in patients with presenting signs and symptoms of esophageal candidiasis e.g., dysphagia or odynophagia.
Endoscopist may or may not decide to perform biopsy.
Result
biopsy histology characteristic Candida yeast forms in tissue and culture confirmation of the presence of Candida species
urinalysis, random or fasting blood glucose, or glucose tolerance test to exclude diabetes
Test
Performed in patients where presence of risk factors is not already evident from the history and exam.
Result
result indicating glucose intolerance in the presence of prediabetes or diabetes
HIV antibody test
Test
Performed in patients where presence of risk factors is not already evident from the history and exam.
Result
positive result if HIV infection is the underlying cause
sialometry
Test
Diagnosis of hyposalivation/xerostomia is usually established from the history and clinical exam.
This test is not always performed, but may be used subsequently to confirm the diagnosis.
Result
reduced salivary flow in cases of xerostomia
electrolyte panel
Test
Performed in patients where presence of risk factors is not already evident from the history and exam, to exclude endocrinopathy (e.g., diabetes mellitus, hypoparathyroidism, pregnancy, hypoadrenalism).
Further investigations will be necessary to confirm specific abnormality.
Result
abnormal result based on type of disorder
Use of this content is subject to our disclaimer