Abstract: TH-PO1216
Uremic Stomatitis Mimicking Oral Candidiasis: An Early Oral Clue to Kidney Disease in a Pediatric Patient
Session Information
- Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Petruzzi, Massimo, Dental School of University of Bari “Aldo Moro", Bari, Italy
- Strippoli, Giovanni, Department of Precision and Regenerative Medicine and Ionian Area, Bari, Italy
Introduction
Uremic stomatitis is a rare manifestation of advanced kidney dysfunction and is exceptionally uncommon in children. Because it presents with diffuse white oral plaques, it may mimic candidiasis and delay recognition of renal disease.
Case Description
A 13-year-old girl referred for persistent diffuse white oral lesions lasting three weeks despite empirical antifungal mouth-rinse therapy for presumed candidiasis. She denied oral burning/dysgeusia; reported tongue biting. Examination showed extensive adherent white plaques involving buccal mucosa, floor of mouth, lateral tongue and gingiva, associated with halitosis.
Family history: monozygotic twin with end-stage kidney disease awaiting transplantation. Given the unusual lesion distribution, lack of response to antifungal therapy and nephrologic family history, systemic evaluation was recommended.
Laboratory testing: severe renal dysfunction with elevated uremic indices. Clinical, laboratory, and familial findings supported uremic stomatitis rather than candidiasis. Following nephrologic management, the oral lesions improved.
Discussion
Antifungal treatment failure, diffuse keratotic lesions, halitosis, severe azotemia, and regression after nephrologic treatment supported uremic stomatitis. The temporal association between renal improvement and lesion resolution further supports a uremia-related pathogenesis.
TEACHING POINTS
Persistent diffuse white oral plaques in children should not automatically be attributed to candidiasis, particularly after antifungal treatment failure. Although rare in pediatric patients, uremic stomatitis may represent an early clue to severe kidney dysfunction. Integration of oral findings, family history, and systemic evaluation can accelerate nephrologic diagnosis and management.