Candidiasis

Medicine > Infection

Background knowledge 🧠

Definition

Candidiasis is a fungal infection caused by Candida species, most commonly Candida albicans.
Can affect various body sites, including oral cavity, genital area, skin, and systemic.

Epidemiology

Common in immunocompromised individuals (HIV, chemotherapy, diabetes).
High prevalence in hospital settings due to invasive procedures.
Oral candidiasis is frequent in infants and elderly.

Aetiology and Pathophysiology

Disruption of normal flora balance allows overgrowth of Candida.
Use of broad-spectrum antibiotics is a common predisposing factor.
Immunosuppression (HIV, steroids) increases risk.
Hyperglycaemia promotes Candida growth.

Types

Oral Candidiasis (Thrush).
Vulvovaginal Candidiasis.
Cutaneous Candidiasis.
Invasive Candidiasis.
Chronic Mucocutaneous .

Clinical Features 🌡️

Symptoms

White patches in mouth (oral).
Itching and discharge (vaginal).
Red, itchy skin (cutaneous).
Fever and chills (invasive).

Signs

Erythematous base under white patches (oral).
Erythema and oedema of vaginal mucosa.
Satellite lesions on skin (cutaneous).
Signs of sepsis (invasive).

Investigations 🧪

Tests

Microscopy and culture of samples (oral, vaginal, cutaneous).
Blood cultures (invasive).
Serological tests for specific antigens (invasive).
PCR assays for Candida DNA (invasive).

Management 🥼

Management

Topical antifungals for oral/vaginal/cutaneous (e.g. nystatin, clotrimazole).
Oral antifungals for extensive or refractory cases.
Intravenous antifungals for invasive infections (e.g., fluconazole, echinocandins).
Identify and manage underlying conditions (e.g., diabetes, immunosuppression).

Complications

Esophagitis (oral).
Recurrent infections.
Systemic spread (invasive).
Organ dysfunction (invasive).
Resistance to antifungal treatment.

Prognosis

Good prognosis for localised infections with appropriate treatment.
Poor prognosis for invasive infections, especially in immunocompromised patients.
Importance of early diagnosis and treatment.

Key points

Candidiasis is common in immunocompromised individuals.
Early recognition and appropriate treatment are crucial.
Preventive measures include maintaining good hygiene and managing underlying conditions.

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