Candidiasis

Background

• Candidiasis encompasses a wide array of local or invasive fungal infections caused by the Candida genus and infect more than 250,000 patients worldwide per year
• Candida yeasts (most commonly Candida albicans) are normal flora that live on the skin and mucous membranes, but cause infection with overgrowth and vary in clinical presentation depending on the area infected
• Local mucocutaneous candida infections: oropharyngeal candidiasis, esophagitis, vulvovaginitis, balanitis, chronic mucocutaneous candidiasis, and mastitis
• Invasive candida infections: Fungal UTI, Meningitis, Endocarditis, Empyema, Mediastinitis, Pericarditis

General Risk Factors

• Skin maceration
• Immunosupression: HIV/AIDS, Corticosteroid use, Chemotherapy, Immunomodulators
• Broad spectrum antibiotic use
• Diabetes Mellitus
• Oral Contraceptive use
• Hematologic Malignancy
• Central Venous Catheters use
• Total Parenteral nutrition use
• Neutropenia

Local Candida Infections

Oropharyngeal Candidiasis (thrush)

Oral Candidiasis, Wikipedia

• Most commonly seen in infants, immunocompromised, older adults with dentures
• Clinical features
  • cotton sensation in mouth, loss of taste
• Diagnosis
  • pseudomembrane white plaques adhered to oral mucosa, tongue, palate, or oropharynx
  • Budding yeast on KOH prep of skin scrapings using a tongue depressor

Esophageal Candidiasis

Esophageal Candidiasis, OPENi-An

• Most commonly seen in HIV patients (AIDS-defining illness)
• Clinical Features
  • odynophagia
• Diagnosis
  • thick, white, linear esophageal plaques on endoscopy

Cutaneous Candidiasis

• • erythematous, macerated, intertriginous plaques with pustules

Chronic Mucocutaneous Candidiasis

Candida Vulvovaginitis

• Most commonly seen in females in high estrogen states: pregnancy, oral contraceptive use
• Clinical Features
  • vulvar pruritis, dyspareunia, dysuria
• Diagnosis
  • cotton cheese-like non-odorous discharge

Candida Dermatitis

Diaper Dermatitis, OPENi-An

Evaluation

• Candidiasis is primarily diagnosed clinically
• Confirmatory tests available by KOH preparation of skin scrapings revealing budding yeasts with pseudohyphae