Certain Candida species are considered to be commensal organisms within the oral cavity. Indeed, the prevalence of oral yeast in the general population is about 34%. 54 In 24 patients with acute periodontal infection and chemotherapy-induced myelosuppression, microorganisms were detected in high concentrations in subgingival pockets with a predominance of Staphylococcus epidermidis, C. albicans, S. aureus, and Pseudomonas aeruginosa, with combinations of these detected in some patients. 54 Raber-Durlacher et al.,55 addressed the pathogenesis of periodontal disease and the possibility of transmission of systemic subgingival microorganisms in patients with cancer treated with chemotherapy.

Those authors reported that oral infections are larger problems, mainly because there is a higher risk of infections spread from microorganisms of the mouth during the neutropenia MK-2206 occurring after chemotherapy. Thus, the inflamed periodontal tissues may act as a focus of infection, bringing significant morbidity and, in some cases can become life-threatening. Still, there is evidence that gingivitis and periodontitis are associated with fever and sepsis in these patients, because the ulcerated epithelium of periodontal pockets may serve as a route of entry of microorganisms into the bloodstream, and the propagation of systemic endotoxins and other inflammatory

mediators. Jewtuchowicz et al.56 identified different species of yeasts using click here conventional mycological methods and specific polymerase chain reaction (PCR) assays from samples at sites of periodontal disease isolated from immunocompromised patients, such as those with advanced HIV infection. Amongst 76 fungal organisms isolated, C. dubliniensis comprised 10.5% of total,

which corresponded to 4.4% of patients studied. C. albicans was the most frequently isolated species of yeast. However, Sardi et al.9 detected some species of Candida, using the PCR method, in higher quantities in diabetic patients when compared with non-diabetic patients with chronic periodontal disease. C. albicans were found in 57.3%, C. dubliniensis in 75.6%, C. tropicalis in 15.85% and C. glabrata in 4.87% of the periodontal pockets of diabetic patients. For non-diabetic patients, 19.17% and 13.69% of the periodontal sites presented C. albicans and C. dubliniensis, respectively. Calpain C. tropicalis and C. glabrata were not found in the periodontal pocket of non-diabetic patients. Urzúa et al. 57 analysed the composition of the yeast microbiota present in the mucosal and subgingival sites of healthy individuals and patients with aggressive and chronic periodontitis, using phenotypic and genotypic methods. Despite the varied profiles of the species present in the mucosa of the three groups analysed, only C. albicans and C. dubliniensis were capable of colonizing the periodontal pockets in patients with chronic periodontitis, whilst only C.