Candidiasis



Candidiasis


Irina Margaritescu, MD, DipRCPath

Bruce R. Smoller, MD










Red, moist, glistening, macerated papules and plaques image and satellite pustules image located in a submammary fold are typical for candidal intertrigo.






Biopsy taken from a satellite pustule shows a subcorneal and intraepidermal pustular dermatitis. Similar findings can be seen in psoriasis and dermatophytosis.


TERMINOLOGY


Synonyms



  • Candidiasis


  • Moniliasis


  • Thrush


  • Oidiomycosis


Definitions



  • Common superficial infection of skin and mucous membranes caused by yeasts of genus Candida


ETIOLOGY/PATHOGENESIS


Infectious Agents



  • C. albicans is the predominant causal organism of most candidal infections



    • Oval yeast 2-6 by 3-9 µm in size


    • Produce budding cells, pseudohyphae, and true hyphae


  • Other species, including C. krusei, C. glabrata, C. dubliniensis, and C. inconspicua isolated from severely immunocompromised patients


Pathogenesis



  • C. albicans is not a normal cutaneous saprophyte but usually colonizes oropharynx, gastrointestinal tract, and vagina


  • Alteration in host defenses, either localized or generalized, allows organism to become pathogenic



    • Factors predisposing to infection include



      • Mechanical factors (trauma, occlusion)


      • Nutritional factors (iron deficiency, malnutrition)


      • Physiologic alteration (menses, pregnancy)


      • Systemic illnesses (diabetes mellitus, malignancy, uremia, immunodeficiency states)


      • Iatrogenic causes (antibiotics, steroids)


    • Virulence factors include surface adhesion molecules and proteinase enzymes


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Common in groups at risk (immunocompromised patients)


  • Age



    • Any age


  • Gender



    • Both sexes


Presentation



  • Various mucosal and cutaneous manifestations


  • Oral candidiasis may appear in acute or chronic forms



    • Acute pseudomembranous candidiasis or thrush



      • Most common form of oral candidiasis


      • Occurs in neonates or in adults usually secondary to local or general predisposing factors


      • Discrete white patches on buccal mucosa, tongue, palate, and gingivae, which, when removed, leave a raw and brightly erythematous surface


    • Acute erythematous (atrophic) candidiasis



      • May occur de novo or after sloughing of pseudomembrane


      • Commonly associated with antibiotics and steroid treatments


      • Marked soreness and depapillated erythematous areas on dorsal surface of tongue


    • Chronic pseudomembranous candidiasis



      • Occurs principally in immunocompromised patients


      • Very persistent lesions


      • Very similar clinically to acute pseudomembranous form


    • Chronic erythematous candidiasis (denture stomatitis)

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Candidiasis

Full access? Get Clinical Tree

Get Clinical Tree app for offline access