Candidiasis: Difference between revisions

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==Clinical Features==
==Clinical Features==
===Local Candida Infections===
===Local Candida Infections===
*Mouth: [[Oropharyngeal candidiasis]] (thrush) [[File:Oral candidiasis.jpg|thumb|Oral Candidiasis]]
*Mouth: [[Oropharyngeal candidiasis]] (thrush)  
*Esophagus: [[Esophageal candidiasis]] [[File:Oral Candidiasis.jpg|thumb|Esophageal Candidiasis]]
*Esophagus: [[Esophageal candidiasis]]  
*Vulva/vagina: [[Candida vulvovaginitis]] [[File:Candida vaginitis.JPG|thumb|Candida vaginitis]]
*Vulva/vagina: [[Candida vulvovaginitis]]  
*Skin lesions: '''[[Candida dermatitis]]''' [[File:Diaper dermatitis.png|thumb|Diaper Dermatitis]]
*Skin lesions: '''[[Candida dermatitis]]'''  
===Systemic===
===Systemic===
*hematogenous, central line cathether, intravenous catheter, [[Candiduria|indwelling foley catheter]]: [[Invasive candidiasis]]
*hematogenous, central line cathether, intravenous catheter, [[Candiduria|indwelling foley catheter]]: [[Invasive candidiasis]]
<gallery>
[[File:Oral candidiasis.jpg|Oral Candidiasis]]
[[File:Oral Candidiasis.jpg|Esophageal Candidiasis]]
[[File:Candida vaginitis.JPG|Candida vaginitis]]
[[File:Diaper dermatitis.png|Diaper Dermatitis]]
</gallery>


==Evaluation==
==Evaluation==

Revision as of 13:31, 4 September 2016

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 [1]
  • Candida yeasts (most commonly Candida albicans) are normal flora that live on the skin and mucous membranes, but may cause infection with overgrowth and vary in clinical presentation depending on the infected area
  • Local mucocutaneous candida infections: oropharyngeal candidiasis, esophagitis, vulvovaginitis, balanitis, chronic mucocutaneous candidiasis, and mastitis [2]
  • Invasive candida infections: Fungal UTI, Meningitis, Endocarditis, Empyema, Mediastinitis, Pericarditis

Risk Factors

  • Skin maceration
  • Immunosuppression: HIV/AIDS, Corticosteroid use, Chemotherapy, Immunomodulators [2]
  • Broad spectrum antibiotic use
  • Diabetes Mellitus
  • Oral Contraceptive use
  • Hematologic Malignancy
  • Central Venous Catheters use
  • Total Parenteral nutrition use
  • Neutropenia

Clinical Features

Local Candida Infections

Systemic

Evaluation

  • Local candidiasis is primarily clinically diagnosed based on lesion characteristics and appearance
  • Confirmatory tests: KOH preparation of lesion scrapings, vaginal wet mount, culture, or endoscopic biopsy reveal budding yeast with pseudohyphae

Management

  • Local: Topical anti-fungal (Nystatin, azoles) or oral azole
  • Invasive: Intravenous Echinocandins (Caspofungin, Micafungin)

Disposition

  • Local infections can be managed on an outpatient basis
  • Invasive infection will be managed with IV antibiotics and requires prolonged hospitalization

See Also

External Links

References

  1. Candidiasis. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/fungal/diseases/candidiasis/. Published June 12, 2015. Accessed August 25, 2016.
  2. 2.0 2.1 Kauffmann CA. Overview of Candida Infections. UptoDate. 2016.