CHAPTER 187: CANDIDIASIS

- albicans- common cause of mucosal candidiasis and candidemia

major route: intravenous catheters.
Oropharyngeal trush- occurs in neonates, DM
Vulvovaginal candidiasis- 3rd trimester of pregnancy
Oral trush- discrete confluent adherent white plaques on the oral and pharyngeal mucosapainless,
fissuring at the corners of mouth
Cutaneous candidiasis- red macerated ,aronychia, balinitis, pruritus ani
Candidal granuloma- circumscribed hyperkeratotic skin lesions
Esophageal candidiasis- can cause substernal pain or a form of obstruction
Biopsy/Brushing- for diagnosis
Candida esophagitis- bleeding and impaired alimentation
Candidemia-origin : intravenous catheter
-can cause retina lesions
Chronic Disseminated Candidiasis- originates from intestinal seeding of the portal and venous
circulation
Arthritis- most commonly on the knee,prosthetic
DX: Wet smear- pseudohyphae
Culture- confirmation
Blood culture- sepsis and endocarditis
Tx: a) Cutaneous candidiasis
- reduce moisture and chafing plus topical antifungal in nonocclusive base.
-nystatin, cicliprox, azole
b) Candida vulvovaginitis
- fluconazole caps more convenient
c) Oral Candidiasis
-clotrimazole troches 5x a day
d) Esophagitis
- oral fluconazole
e) Bladder thrush
-bladder irrigations w/ Amphotericin B
f) Deeply invasive candidiasis
-IV Amphotericin B
g) endocarditis
-fluconazole
h) Candida endophtalmitis
- IV Amphotericin B w/ or w/o flucytosine
i) osteomyelitis
-debridement w/ antifungal therapy
FLUCONAZOLE Prophylaxis
- for bone marrow transplants (allogenic)