candidiasis Flashcards
what is candidiasis?
Candidiasis refers to a mucocutaneous fungal infection with a Candida species, most commonly Candida albicans*
what are RF for candidiasis?
Site: moist body folds, damage to skin/mucosal barriers, indwelling medical devices
Systemic: immunosuppression, recent antibiotics, diabetes mellitus, iron deficiency anaemia, pregnancy
Exposure: hospitalisation
features of candidiasis?
Vulvovaginal: pruritis, thick white discharge, burning sensation
Cutaneous: erythematous, scaling macules with smaller outlying lesions
Oral: mucosal erythema with white flecks
Systemic: severe illness in a vulnerable patient e.g. patients
what ix can you do for candidiasis?
Swabs - fungal and/or bacterial
Bloods - FBC, iron studies, U&E, LFT’s, clotting,CRP, HbA1c, HIV testing, ABG/VBG
Specific investigations for differential diagnoses e.g. STI screen, urine dip
Pregnancy test if appropriate
general mx for candidiasis?
A-E approach, consider sepsis 6
Treatment involves systemic antifungals such as echinocandin, fluconazole or amphotericin B, alongside supportive measures.
mx for cutaneous candidiasis?
Conservative: advice on skincare, changing nappies regularly, weight loss if appropriate
Topical imidazole which is antifungal
tx for vulvovaginal candidiasis?
Conservative: washing with soap substitute, avoiding tight clothing, avoiding irritants
Medical: oral fluconazole or clotrimazole cream or pessary (in pregnancy)
An induction & maintenance regime of oral fluconazole may be needed
These treatments may be given with or without topical imidazole for vulval symptoms
what do you do for oral candidiasis?
Conservative: advice on good oral hygiene
Medical: miconazole oral gel first line, nystatin suspension second line
If HIV positive: oral fluconazole 200 mg on day one, followed by 100-200mg daily for 14 days
complications of candidiaisis?
Worsening of symptoms
Recurrence
Secondary bacterial infection
Invasive disease, organ dysfunction & shock
