Candidiasis

Candidiasis

1. General characteristics

   • Disease: Cutaneous to systemic
   • Etiological agent: Candida spp.
     • C. albicans -most common, part of normal flora

2. Clin. issues & dx

   • Found in skin, mouth, intestines and vagina in healthy individuals
   • Oral and vaginal candidiasis or thrush - creamy white patch
     • Dx: Clinical impression, scraping/swabbing - yeast and hyphal forms (microscope)
   • Skin - clinical manifestations variable dependent on anatomical site, intertriginous area - red plaques with satellite pustules, candidal paronychia - inflammation & purulence at nail folds,
   • Alteration of normal bacterial flora with antibiotics, hormonal therapy, pregnancy & diabetes encourage Candida colonisation and infection
   • Immunocompromised - invasive candidiasis likely to occur
   • Iatrogenic infections e.g. catheter
   • Chronic mucocutaneous candidiasis - rare, seen in people with lymphocytes defects

3. Treatment

   • Depends on the immunologic status
     • Immunocompetent - topical azoles or nystatin
     • Extensive infection - presdisposing causes need to be known, tx - systemic agents e.g. fluconazole, itraconazole, ampho B and caspofungin