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

The aim of this study was to analyze the spectrum of <i>Candida</i> manifestations in the orofacial region to address the lack of comprehensive data in the diverse pediatric population. This retrospective study included all positive <i>Candida</i> 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. <i>Candida</i> infection sites included oral mucosa, dental abscesses and otitis media. <i>Candida</i> 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 <i>Candida</i> in otitis media. Whereas in dental abscesses, <i>Candida</i> had a significant proportion independent of prior antibiotic use. Non-<i>albicans</i> subspecies, particularly <i>Candida parapsilosis</i>, were notably more prevalent in the middle ear compared to oral and dental infections. <i>Candida</i> manifests in various forms in the orofacial region, with different characteristics and species distributions. Further investigations are needed to better understand the role of <i>Candida</i> as a symptom or a contributor to an underlying condition.