Candida spp.

Dr. Mahesh Adhikari

 OPPORTUNISTIC MYCOSES
• Candidiasis
• Cryptococcosis
• Aspergillosis
• Zygomycosis
• Other: Trichosporonosis, fusariosis,
penicillosis……
 CANDIDIASIS
• Most commonly encountered
opportunistic mycoses worldwide

• Endogenous infection
 MOST COMMONLY ISOLATED
CANDIDA SPECIES
C. albicans
C. tropicalis
C. parapsilosis
C. glabrata
C. krusei
C. guillermondii
C. dublinensis
 Candida
MORPHOLOGICAL FEATURES
• Microscopic appearance- Budding yeast cells
Pseudohyphae, true hyphae
• Macroscopic appearance on SDA- Creamy yeast
colonies
• Germ tube (C. albicans, C. dubliniensis)
• Chlamydospore (C. albicans, C. dubliniensis)
• Identification Germ tube, fermentation
and assimilation reactions
 Candida
PATHOGENICITY
• Attachment
• Adherence to plastic surfaces (catheter,
prosthetic valve..)
• Protease
• Phospholipase
• Phenotypic switching; formation of
pseudohyphae
 CANDIDIASIS
Clinical manifestations-I
1. Cutaneous and Subcutaneous
• Oral
• Vaginal
• Onychomycosis
• Dermatitis
• Diaper rash
 CANDIDIASIS
Clinical manifestations-II

2. Systemic • Peritonitis
• Esophagitis • Hepatosplenic
• Pulmonary inf. • Endophthalmitis
• Cystitis
• Arthritis
• Pyelonephritis
• Endocarditis
• Osteomyelitis
• Myocarditis • Meningitis
• Skin lesions
 CANDIDIASIS
Diagnosis
• Direct microscopic examination
Yeast cells, pseudohyphae
Germ tube test
• Culture
SDA
• Serology
Detection of antigen
(ELISA, RIA, IF, latex agglutination)
 Germ-tube test
• Put 0.5 ml of human
serum in a 10 x 75 mm
tube.
• Make a light suspension of
the suspect yeast colonies
by touching 1-2 large
colonies with a sterile
straight wire and then
inoculating the serum.
Germ-tube test
• Incubate the tube for 2-3 : Positive
Germ-tube
test : Negative
hours in a 35 - 37°C (C. albicans)

incubator.
 Germ-tube test
Germ-tube
• Place a drop of the suspension on a Germ-tube test :
slide using a pipette and coverslip. test : Negative
Positive
• Examine the wet mount (C. albicans)
microscopically for production of
germ tubes (long tube-like
projections extending out from the
C. glabrata
yeast cells).
No
constriction

Note: Too large of an inoculum will inhibit germ tube formation.

Warning: Do not over-incubate the tube. Candida tropicalis may
produce pseudo-germ tubes after 3 hours of incubation.
 CANDIDIASIS
Treatment
• Cutaneous
Topical antifungal: Ketoconazole, nystatin

• Systemic
Amphotericin B
Fluconazole,
Itraconazole
Thank You