口腔念珠菌病

体格检查

若患者有口咽念珠菌病已知危险因素，但并无口腔症状，建议行体格检查以确认是否存在无症状的病灶。这对于免疫力低下的患者尤为重要，因为对他们而言，口咽念珠菌感染如果不治疗，可能发展为局部侵袭或播散。对于接受肿瘤放疗或化疗的患者，即使未发现任何病灶，仍可预防性使用抗真菌药物，以避免念珠菌局部感染或系统性累及。[53]Meunier F, Paesmans M, Autier P. Value of antifungal prophylaxis with antifungal drugs against oropharyngeal candidiasis in cancer patients. Eur J Cancer B Oral Oncol. 1994;30B:196-199.http://www.ncbi.nlm.nih.gov/pubmed/7920166?tool=bestpractice.com[54]Clarkson JE, Worthington HV, Eden OB. Interventions for preventing oral candidiasis for patients with cancer receiving treatment. Cochrane Database Syst Rev. 2007;(1):CD003807.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003807.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17253497?tool=bestpractice.com证据 A接受癌症治疗患者的预防性抗真菌治疗：高级别证据表明，对于接受癌症治疗的患者，接受胃肠道吸收或部分吸收抗真菌药物预防性治疗的患者与未接受者相比，发生口咽念珠菌病的可能更小。[53]Meunier F, Paesmans M, Autier P. Value of antifungal prophylaxis with antifungal drugs against oropharyngeal candidiasis in cancer patients. Eur J Cancer B Oral Oncol. 1994;30B:196-199.http://www.ncbi.nlm.nih.gov/pubmed/7920166?tool=bestpractice.com[54]Clarkson JE, Worthington HV, Eden OB. Interventions for preventing oral candidiasis for patients with cancer receiving treatment. Cochrane Database Syst Rev. 2007;(1):CD003807.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003807.pub3/fullhttp://www.ncbi.nlm.nih.gov/pubmed/17253497?tool=bestpractice.com系统评价或者受试者＞200名的随机对照临床试验（RCT）。也可用于骨髓或器官移植，及HIV感染相关免疫低下人群。