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Candidiasis

Background knowledge ๐Ÿง 

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
  • Hyperglycemia promotes Candida growth

Types

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

Clinical Features ๐ŸŒก๏ธ

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 edema of vaginal mucosa
  • Satellite lesions on skin (cutaneous)
  • Signs of sepsis (invasive)

Investigations ๐Ÿงช

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 ๐Ÿฅผ

Management

  • Topical antifungalsfor 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 localized 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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