KANDIDIAS ORAL PADA PENDERITA ANEMIA DEFISIENSI BESI (Fe) DAN PENATALAKSANAANNYA

Latar belakang : Anemia defisiensi besi adalah anemia mikrositik disebabkan kehilangan banyak darah pad a menstruasi yang panjang, perdarahan saluran gastrointestinal, gasterektomi atau malabsorpsi yang menyebabkan berkurangnya absorpsi Fe. Faktor predisposisi kandidiasis adalah terganggunya ekologi mulut atau perubahan mikrobiologi mulut disebabkan faktor malnutrisi( defisiensi besi, asam folat, vitamin B12) dan umur yang sangat tua. Tujuan : Melaporkan kasus Anemia defisiensi besi disertai kandidiasis mulut dan penatalaksanaannya. Laporan kasus : Seorang laki laki 69 tahun di rujuk oleh teman sejawat karena gusi bengkak, mulut terasa sakit dan sulit menelan makanan. Sebulan lalu dirawat di rumah sakit dan mondok selama satu minggu tapi tidak ada peru bahan, berat badan turun 25 kg. Wajah dan konjungtiva pucat, drolling, dan terlihat lemah. Suhu badan 37° CTD : 125/80 mm HgBerat bad an : 50KgLimfonodi submandibularis kanan dan kiri membesar dan sakit tekan. Wajah simetris. Sudut bibir kanan dan kiri terdapat angular kheilitis, mukosa pipi, palatum hiperemi, mukosa gingiva stipling menghilang, hiperemi, Permukaan dorsallidah halus, hiperemi, depapillasi . OHI : jelekair ludah kental, hipersalivasi. Banyak karies gigi dan sisa radiks. Penatalaksanaan : Pemeriksaan air ludah dengan larutan KOH terlihat adanya hipa. Pemeriksaan darah rutin dan profil Fe semua dalam batas normal kecuali RBC: 3,73.106/µLHGB: 11,0 g/dlHCT: 32,2%Fe 29,00 µg/dl (dibawah normal). Terapi dengan obat kumur Perhidrol 3%, Nistatin solution 3 x sehari. Zegase tablet 2 x sehari . Parasetamol tablet bila perlu. Enam belas hari kemudian pasien sembuh dan dikembalikan dokter yang merujuk. Maj Ked GiJuni 201219(1): 77-8

Prevalence and identification of oral candida species in patients with type 2 diabetes in Yogyakarta

Patients with diabetes are prone to recurring and even resistant Candidiasis, making treatment challenging. Many hypotheses proposed related to susceptibility of diabetic patients to Candida. The prevalence and species of Candida in a particular diabetic community might be different compared to other diabetic community. This study aimed to determine the prevalence of Candida colony and its species in the oral cavity of diabetic patients included in the CDM (Chronic Disease Management) program in Yogyakarta. One hundred patients with type 2 diabetes (n= 100) were recruited as the subjects of this study. The subjects were classified into controlled and uncontrolled Diabetes mellitus (DM). Samples of oral rinse solution were collected to determine the species of Candida and number of Candida colonies using CHROMagar Candida medium. There were 47 and 53 of subjects with controlled and uncontrolled DM, respectively. The mean number of Candida colony in the subjects with controlled diabetes (1003.13) was higher than that in the subjects with uncontrolled diabetes (478.43). The Candida colony most commonly identified in the subjects with controlled and uncontrolled diabetes were C. albicans and C. glabrata, respectively. Female patients had higher mean number of Candida colony (859.51) compared to male (299.21). The Candida colony most often identified in both genders was C. albicans. In addition, the subjects of this study consisted of 83 geriatric subjects and 17 non geriatric subjects, in which the mean number of Candida colony in the geriatric subjects (761.77) was higher than that in the non-geriatric subjects (545.71). The Candida colony most often identified in the geriatric subjects and non-geriatric subjects was C. albicans and C. glabrata, respectively. The Mann Whitney test demonstrated that there was a significant difference (p = 0.009) of the mean number of Candida colony between male and female. However, there was no significant difference of the mean number of Candida colony between ages (p = 0.060) and diabetic status (p=0.175). It can be concluded that the Candida species most commonly identified in all the subjects was Candida albicans with the mean colony number of 349.96, followed by C. glabrata (225.97), C. krusei (144.91), C. tropicalis (3.67), and other species (2.02)