CANDIDIASIS

DIAGNOSTIC CRITERIA

Definition : Mucocutaneous disorder caused by Candida, a species of fungus normally found in mouth, vagina, and faces of normal people.

1. an opportunistic infection that could cause oesophagitis (dysphagia), vulvo-vaginitis (thin to thick /whitish vaginal secretion), balanitis, gastritis, angular cheilitis at the corners of the mouth, and oropharyngeal candidiasis (white raised painless distinct patches).
2. AIDS patients and other immuno-suppressed cases present with severe oral candidiasis, and in severe immuno-suppression can lead to systemic spread, particularly to the kidney (funguria).
3. Catheter associated fungaemia can occur in hospitals, and rarely systemic invasion can follow, calling for diagnosis by tissue biopsy or evidence of retinal disease (fluffy white retinal infiltrates extending into the vitreous).
4. Gram stain reveals gram positive yeast forms, and the organism can be cultured (but could be culture from ‘normal flora’ as well).

Prognosis : In immuno-competent individuals the disease runs a benign course and carries an excellent prognosis but in the immuno-compromised, can cause much morbidity, and can contribute to mortahty.

MANAGEMENT

Principles:

Always treated as outpatient. Investigate patients with severe features, for immune deficiency. Always consider the possibility of AIDS in an ill patient with severe oral candidiasis.

 

General Measures

• Cotton underweart prove perineal ventilation.
• Regular inspection of possible sites for candidial overgrowth in sick patients on prolonged antibiotic therapy.
• Remove catheter, if catheter related.

Patient teaching

1. lmmuno-compromised to be informed of possibility of candidiasis when on prolonged antibiotic therapy.