Microbiological testing of oral and linguistic swab includes:
- Microscopic examination after Gram staining
- Cultivation for aerobic microorganisms
- Cultivation for fungi
- Antibiogram or antifungal (susceptibility test) for the isolated microorganisms that will be considered necessary
Oral and lingual mucosal disorders usually present as acute conditions and may be a result of the (microbiome) disorder of the oral cavity or may occur as a result of a chronic, low degree of infection.
Mucosal infections of the oral cavity are often associated with microbial biofilms that can form on surfaces present in the oral cavity such as teeth and dentures.
Gum infections (gingivitis, including acute ulcerative gingivitis) and periodontal tissues (periodontitis) are the most common infections in the oral cavity.
Oral mucositis is a painful complication of chemotherapy or head and neck radiotherapy caused by the direct cytotoxicity of the therapeutic regimens. Infections, usually with fungi and oral germs, can aggravate the problem and microbiological testing can help guide treatment.
Erythritic and pseudomembranous candidiasis
Erythritic and pseudomembranous candidiasis are the most common clinical manifestations of oral fungal infections. Infections may include the mucosal surfaces of the cheeks, tongue (dorsal and abdominal surface), and the hard and soft palate. The most common cause is Candida albicans while other Candida species such as C. glabrata are rarely isolated, either alone or in combination with C. albicans. This is particularly common in immunosuppressed or patients with a history of prolonged antifungal therapy. Atrophic candidiasis (denture stomatitis) can occur in the oral mucosa beneath the surface of the artificial denture, especially when patients sleep with their dentures or have a dry mouth. Isolated Candida species are important to identify and control their susceptibility, as they may be resistant to first-line antifungal agents and may be responsible for resistant or recurrent infections. Rarely, fungi can colonize and infect the sinuses and cause damage to the palate.
Corneal lobitis and perinatal infections
Corneal ulceration and peritoneal infections are common infections that affect the corners of the mouth and the ears and are usually caused by oral microbiota germs and are more common than those associated with denture stomatitis. The infection may be due to Staphylococcus aureus, Candida species or group A streptococci.
Patients who have severe medical problems with reduced salivary flow and parenteral nutrition may develop Staphylococcal mucositis caused by Staphylococcus aureus. Enterobacteria may play a role in very severe cases. Erythritic changes in the oral mucosa cannot be distinguished clinically from those of candidiasis, necessitating microbiological research. The results should be interpreted in relation to the existing clinical picture as there may be an asymptomatic presence of S. aureus or Enterobacteria. Oral hygiene measures are usually sufficient to solve the clinical problem while antibiotics are usually not required.
There are many non-infectious causes of oral ulcers, such as traumatic ulcers, recurrent foot ulcers, inflammatory conditions and malignant lesions. Infectious causes of oral ulcers are usually viral (eg, herpes simplex) whereas unusual bacterial causes of oral ulcers are syphilis and tuberculosis while other rarer causes include fungal infections such as histoplasmosis.
Borrelia vincentii and some species of Fusobacterium are associated with Vincent stomatitis (or acute necrotic osteomyelitis) which is characterized by ulceration of the pharynx or gums and occurs in adults with poor oral hygiene or severe systemic disease.
Laboratory test results are the most important parameter for the diagnosis and monitoring of all pathological conditions. 70%-80% of diagnostic decisions are based on laboratory tests. Correct interpretation of laboratory results allows a doctor to distinguish "healthy" from "diseased".
Laboratory test results should not be interpreted from the numerical result of a single analysis. Test results should be interpreted in relation to each individual case and family history, clinical findings and the results of other laboratory tests and information. Your personal physician should explain the importance of your test results.
At Diagnostiki Athinon we answer any questions you may have about the test you perform in our laboratory and we contact your doctor to get the best possible medical care.