CANDIDIASIS
Definition
Candidiasis is a yeast, or fungal, infection caused by several species of Candida, the most predominant being Candida albicans. Although approximately 80% of healthy individuals will have normal colonisation in the mouth, gastrointestinal tract, vagina, and rectum, most produce bacterial flora to protect against infections. Clinical manifestations vary according to subtype and range from superficial to severe infections. Candidiasis is the fourth leading cause of nosocomial infectious disease. Approximately 75% of women will contract candidiasis of the vagina during their lifetime, and 90% of people diagnosed with HIV/AIDS will develop a Candida infection. The primary subtypes are:
- Oral candidiasis (thrush)
- Perlèche (candidal angular cheilitis)
- Cutaneous disease
- Vulvovaginitis
- Disseminated candidiasis (can affect lungs, liver, spleen, kidneys, heart, brain, and eyes)
- Gastrointestinal candidiasis
- Urinary tract candidiasis
- Candidal endocarditis (often due to damaged or prosthetic cardiac valves, or long-term intravenous catheter use)
- Central nervous system candidiasis (extremely rare)
- Chronic candidiasis (occurs predominantly in immunosuppressed patients)
Aetiology / Risk Factors
- Dermatitis (e.g., contact or primary irritant, seborrheic, atopic)
- Prolonged neutropenia
- Psoriasis
- Bacterial infection
- Cushing's disease
- Obesity
- Histiocytosis
- Pregnancy
- Diabetes
- HIV infection
- Intravenous drug abuse
- Surgery
- Intravascular catheter
- Long-term antibiotic use
Symptoms & Signs
- Fever, malaise
- Hypotension
- Creamy white patches overlying erythematous buccal mucosa (thrush)
- Painful, macerated fissures at the corners of the mouth (perlèche)
- Erythematous skin lesion found most commonly in the groin, between fingers and toes, under the female breast, and in the axilla (cutaneous disease)
- Vulvar erythema, oedema, and pruritus; usually including a curd like discharge (vulvovaginitis)
- Large abscesses and diffuse microabscesses (disseminated candidiasis)
- Erosive lesions of the distal oesophagus and stomach (gastrointestinal candidiasis)
-
Urinary tract infection (urinary tract candidiasis)