Candidiasis

Question 1

Definition

Answer 1

Infection caused by Candida

Question 2

Aetiology

Answer 2

· Caused by 15 different Candida species

· Candida albicans is the MOST COMMON cause of candidiasis in humans

Question 3

Types

Answer 3

· Main types of candidiasis:

o Oral candidiasis
o Oesophageal candidiasis
o Candidal vulvovaginitis
o Candidal skin infections
o Invasive candidal infections

Question 4

Risk factors

Answer 4

o Broad-spectrum antibiotics

o Immunocompromise (e.g. HIV, corticosteroids)

o Central venous lines

o Cushing’s disease

o Diabetes mellitus

o GI tract surgery

Question 5

Epidemiology

Answer 5

· 60% of the healthy adult population are carriers

· Candidiasis occurs in over 80% of people with HIV

· Candida is one of the most common causes of invasive fungal infections in the Western world

Question 6

Presenting symptoms (oral candidiasis)

Answer 6

o Oral Thrush (pseudomembranous oral candidiasis) - curd-like white patches in the mouth, which can be removed easily revealing an underlying red base. Most common in neonates

o There are lots of subtypes of oral candidiasis with slightly different features but the main features are: redness of the tongue and mouth, white plaques

Question 7

Presenting symptoms (oesophageal candidiasis)

Answer 7

o Dysphagia

o Pain on swallowing food or fluids

o It is an AIDS-defining illness

Question 8

Presenting symptoms (candidal skin infections)

Answer 8

o Soreness and itching

o Skin appearance can be variable

o Red, moist skin area with ragged, peeling edge and possibly papules and pustules

Question 9

Investigations

Answer 9

· Oral Candidiasis - swabs and cultures are not particularly useful because a lot of normal people have candida in their mouth

· Swabs may be relevant to check for drug-resistance

· Therapeutic trials of antifungal (e.g. fluconazole) can help with diagnosis

· Oesophageal Candidiasis: definitive diagnosis is by endoscopy

· Invasive Candidiasis: blood cultures required if candidaemia is possible