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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Thrush is a condition also known as candidiasis. White or red patches develop on the gums, tongue, cheeks, or roof of the mouth. Thrush is prevented via proper cleaning of dentures, removing dentures for part of the day or night, and soaking them in a prescribed medication. Xerostomia is another condition linked to diabetes mellitus, and is commonly known as dry mouth. There is insufficient saliva, increasing risks for tooth decay and gum disease. There may be mouth pain, cracking of the lips, and sores or infections. Xerostomia results in problems chewing, eating, and even swallowing or talking. Humidifying devices increase moisture in the air surrounding the patient. There may be a need to avoid spicy or salty foods, since they can cause pain in a dry mouth. Oral burning may occur in the mouth because of hyperglycemia. There may be a bitter taste, and symptoms often worsen throughout the day. Oral burning may require changes in diabetes medications. Once the blood glucose is controlled, the condition resolves. Other symptoms in the mouth include sores or ulcers that do not heal, dark spots or holes in the teeth, loose teeth, pain while chewing, altered taste sensations, and chronic bad breath. Some patients have pain chronic pain in the mouth, face, or jaw.
Mouth, tongue, lips and ears
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Thrush occurs in the very young, the very old and in patients who are immunosuppressed or who are taking antibiotics or cytotoxic drugs. Small white papules scrape off easily with a spatula to leave a red surface. If these are mixed with potassium hydroxide, the spores and hyphae are easily seen on direct microscopy (seeFig. 10.04, p. 342) or can be cultured on Sabouraud's medium.
Diabetes
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Sugary urine encourages the bacteria which encourage the yeast infection thrush to thrive. Both diabetic men and women are vulnerable to thrush, but it is more common in women. Symptoms in women include genital itchingwhite dischargepainful sexstinging on urination
Mycobacterium avium complex and Cryptococcus neoformans co-infection in a patient with acquired immunodeficiency syndrome: a case report
Published in Acta Clinica Belgica, 2022
Emilien Gregoire, Benoit François Pirotte, Filip Moerman, Antoine Altdorfer, Laura Gaspard, Eric Firre, Martial Moonen, Gilles Darcis
A 28-year-old Belgian Caucasian patient presented at the emergency department complaining about anorexia, dysphagia, weight loss (more than 10% in 6 months), low-grade fever and headache for several weeks. His medical history consisted of uncomplicated gastro-jejunal by-pass surgery at the age of 18. The patient reported unprotected sex, including insertive and receptive anal intercourse with several male partners during the last few years. HIV test was never performed in the past. There was no history of tobacco use nor recreational drug use. Alcohol consumption was occasional. Vital signs at admission showed tachycardia at 130 beats per minute and central temperature of 37.8°C. Arterial blood pressure and oxygen saturation breathing room air were within normal range. At clinical examination, the patient was conscious and well oriented in time and space, but he showed bradyphrenia and irritability. He was cachectic and had pale teguments and dry skin. Oral thrush on posterior tongue and soft palate was a sign of oral candidiasis. Swollen motile sub centimetric lymph nodes were palpable in the neck, axillary pits and groin area. Ophthalmic examination demonstrated deficit in abduction of left eye, sign of palsy of the sixth facial nerve. The rest of the physical examination was normal.
Granulomatous amoebic encephalitis caused by Acanthamoeba in a patient with AIDS: a challenging diagnosis
Published in Acta Clinica Belgica, 2021
Hsien Lee Lau, Daniela F. De Lima Corvino, Francisco M. Guerra, Amer M. Malik, Paola N. Lichtenberger, Sakir H. Gultekin, Jana M. Ritter, Shantanu Roy, Ibne Karim M. Ali, Jennifer R. Cope, M. Judith D. Post, Jose A. Gonzales Zamora
He was empirically treated with vancomycin and cefepime for a presumptive brain abscess. Given his low CD4 count, toxoplasmosis was considered as one of the possible causes, for which he received treatment with sulfadiazine, pyrimethamine and leucovorin. Fluconazole was also added for oral thrush. Several days later, brain magnetic resonance imaging (MRI) with and without contrast re-demonstrated a right occipitoparietal enhancing lesion with low T1 and high T2 signal measuring approximately 4 cm, with significant edema, leptomeningeal enhancement (Figure 1(b)), and multiple punctate hemorrhages (Figure 1(c)). Further work up for tuberculosis with interferon gamma releasing assay (IGRA) was indeterminate. Additional laboratory studies showed positive CMV (cytomegalovirus) IgG and syphilis IgG titers, with a non-reactive serum RPR (rapid plasma reagin). The remaining work-up that included toxoplasma IgG and PCR (polymerase chain reaction), histoplasma urine antigen, hepatitis serology, Cryptococcus antigen, and blood cultures were all negative. Cerebral spinal fluid (CSF) showed 236 white blood cells with lymphocytosis of 94%, no red blood cells, normal glucose, and elevated protein > 600 mg/dl. CSF studies were negative for toxoplasma PCR, VDRL (Venereal Disease Research Laboratory test), Cryptococcus antigen, MTB (Mycobacterium tuberculosis) PCR, viral encephalitis panel, and cultures; however, EBV (Epstein-Barr virus) PCR was non-negligible with 488 IU/ml. Cytology showed increased lymphoid cells with no evidence of lymphoma. Flow cytometry was unremarkable.
Type 2 diabetes mellitus and oral Candida colonization: Analysis of risk factors in a Sri Lankan cohort
Published in Acta Odontologica Scandinavica, 2019
Asanga Sampath, Manjula Weerasekera, Ayomi Dilhari, Chinthika Gunasekara, Uditha Bulugahapitiya, Neluka Fernando, Lakshman Samaranayake
According to the International Diabetes Federation, diabetes mellitus (DM) is one of the commonest globally prevalent endocrine disorders, and one of the four priority noncommunicable diseases (NCDs) [1,2]. It is also the commonest NCD in South East Asia region. One in five individuals in Sri Lanka are either diabetic or exhibit impaired glucose tolerance [3]. Uncontrolled diabetes predisposes to a variety of superficial and systemic infections [4,5] and oral candidal infections are a common affliction in these individuals [6–8]. Additionally, heavy oral candidal colonization in diabetics with type 2 DM has been associated with oral thrush, periodontitis and dental carries [4,9,10]. Apart from diabetes, there are many other factors which predispose individuals to oral candidal colonization including denture wearing, smoking, xerostomia, use of steroids and broad spectrum antibiotics [11].