A Case of Oral Candidiasis Treated with Fluconazole (Diflucan®) Mouthrinse

Abstract

Oral candidiasis, a common fungal infection in humans, is characterized by the overgrowth of Candida species in the superficial oral epithelial mucosa. The condition is associated with multiple risk factors, including impaired salivary gland function, oral mucosal damage, and long-term antibiotic or corticosteroid use. Several treatment options are available; nystatin and amphotericin B are the most widely used local medications. Recently, fluconazole has emerged as the preferred systemic treatment. We report a case of oral candidiasis in an 83-year-old male diagnosed with bullous pemphigoid in 2017 and previously administered methylprednisolone. He developed oral candidiasis a few months before presentation and was treated with 10 mL nystatin suspension three times daily; unfortunately, the disease was recalcitrant to this treatment and his symptoms showed no improvement over two months. We discontinued nystatin in favor of fluconazole syrup (Diflucan®) administered by rinsing, then swallowing, 5 mL syrup once daily. The lesion improved after one month of treatment. This case demonstrates the efficacy of fluconazole as a primary treatment for oral candidiasis. The act of rinsing the mouth with syrup exposes the oral mucosa to drug, potentially producing a better treatment response than taking the syrup orally without rinsing.