Pediatric Candida Manifestations in the Orofacial Region: A Retrospective Analysis of Different Forms, Risk Factors and Species Distribution

Abstract

The aim of this study was to analyze the spectrum of Candida manifestations in the orofacial region to address the lack of comprehensive data in the diverse pediatric population. This retrospective study included all positive Candida findings in patients aged 0–18 years treated between 2014 and 2023 at a university maxillofacial department in Germany and evaluated associated risk profiles, comorbidities and species distributions. Candida infection sites included oral mucosa, dental abscesses and otitis media. Candida was more frequent in children with pre-existing conditions, particularly immunosuppression, neuromuscular disorders and facial deformities. Tympanostomy tubes and recent antibiotic use were significant risk factors for Candida in otitis media. Whereas in dental abscesses, Candida had a significant proportion independent of prior antibiotic use. Non-albicans subspecies, particularly Candida parapsilosis, were notably more prevalent in the middle ear compared to oral and dental infections. Candida manifests in various forms in the orofacial region, with different characteristics and species distributions. Further investigations are needed to better understand the role of Candida as a symptom or a contributor to an underlying condition.