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Section 3. Summaries of Infectious Diseases
Candidiasis
(Moniliasis, Thrush)
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Mucocutaneous infection results in
oral-pharyngeal (thrush) or vaginal candidiasis; intertriginous
lesions of the gluteal folds, neck, groin, and axilla; paronychia;
and onychia. Dysfunction of T-lymphocytes, other immunologic
disorders, and endocrinologic diseases are associated with chronic
mucocutaneous candidiasis. Oral candidiasis can be the presenting
sign of human immunodeficiency virus (HIV) infection or primary
immunodeficiency. Esophageal and laryngeal candidiasis can occur
in immunocompromised patients. Disseminated or invasive candidiasis
occurs in very low birth weight newborn infants and in immunocompromised
or debilitated hosts, can involve virtually any organ or anatomic
site, and can be rapidly fatal. Candidemia can occur with or
without systemic disease in patients with indwelling vascular
catheters, especially patients receiving prolonged intravenous
infusions with parenteral alimentation or lipids. Candiduria
can occur in patients with indwelling urinary catheters, focal
renal infection, or disseminated disease.
ETIOLOGY: Candida species are yeasts that reproduce by budding.
Candida albicans and some
Candida tropicalis are dimorphic and
form long chains of elongated yeast forms called pseudohyphae.
Candida albicans causes most infections (50%–60%). Other
species, including
C tropicalis, Candida parapsilosis, Candida glabrata, Candida krusei, Candida guilliermondii, Candida lusitaniae,
and
Candida dubliniensis, also can cause serious infections
in immunocompromised hosts.
Candida parapsilosis is second only
to
C albicans as a cause of systemic candidiasis in very low
birth weight neonates.
EPIDEMIOLOGY: Candida albicans is ubiquitous. Like other
Candida species,
C albicans is present on skin and in the mouth, intestinal
tract, and vagina of immunocompetent people. Vulvovaginal candidiasis
is associated with pregnancy, and newborn infants can acquire
the organism in utero, during passage through the vagina, or
postnatally. Mild mucocutaneous infection is common in healthy
infants. Person-to-person transmission occurs rarely. Invasive
. . . [Go to Full Text]
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