An unusual mandibular lesion by Candida Albicans: case report and review of literature

The aim of this work was to describe an unusual mandibular bone lesion due to Candida Albicans (Candida A.) yeats, in an immunocompetent host. Candida A. is a saprophytic microorganism of skin and mucous membranes. Bone involvement, by its action, is rare but recognised entity. When tissues flora is altered by: skin or mucous disruption, immunity disease, diabetes, it results in primary candidiasis, or super infection, that may involve bone district as well. A young female underwent to magnetic resonance that revealed, as occasionally result, an osteolysis of mandibular bone. Computed tomography Denta-scan and Panorex were carried out. Operative inteventation was performed to explore the bony tissue. An extensive bone rarefaction from 3.6 to 3.8 roots was found, without any sharp edges. A conservative treatment was decided, waiting for hystologic exam, that was diagnostic for an osteolytic lesion with Candida A. yeats. A fluconazol and ciprofluoxacin therapy was carried out and a second operative intervention was performed. A further Panorex revealed bone regeneration after one year follow-up. Osteomyelitis lesions induced by Candida A. and its colonization in caries have been largely demonstrated in selected cases, but no one in the literature reviewed showed osteolytic lesions. The patient was an immunocompetent host. A previous orthodontic therapy about eight years ago was referred, so that authors hypothesized a mycotic diffusion from brackets or arch wire during infant age.