Introduction
Candidiasis is a fungal infection caused by a yeast (a type of fungus) called Candida.
-the most common species is Candida albicans
-Candida albicans can exist in both hyphal and yeast forms (dimorphism)
-It can form hyphae and pseudohyphae
-Risk factors: use of oral antibiotics, use of steroids, immunodeficiency, diabetes, pregnancy, birth control pills, obesity and trauma
Symptoms & Signs
-It can appear in different manifestations: Cutaneous candidiasis, oral candidiasis, paronychia, onychomycosis, vulvovaginitis, balanitis, chronic mucocutaneous candidiasis, and disseminated candidiasis
Morphology: Macules, beefy-red patches, plaques with satellite papules and pustules at the periphery
Oral thrush: Whitish-curd-like pseudomembranous lesions over an erythematous base; it “wipes off” with the application of gauze
Onychomycosis: Erythematous swelling of the nail folds
Diagnosis
Clinical features: Whitish, curd-like pseudomembranes
Potassium hydroxide (KOH) preparation: pseudohyphae and budding yeasts
-Candida albicans also shows true hyphae as germ tubes or chlamydospores
Other tests: Blood cultures, antigen and antibody testing, β-D-glucan tests
Treatment
Therapy for candidiasis includes three classes of medications:
1.Azoles: Ketoconazole, Fluconazole,miconazole, clotrimazole, itraconazole, posaconazole, isavuconazole, voriconazole
2.Echinocandins: Caspofungin, Anidulafungin, Micafungin
3.Polyenes: Amphotericin B
Mild disease: Nystatin or azoles
Severe disease: Azoles or echinocandins or amphotericin B