Candidiasis
Candidiasis (also called candidosis or moniliasis) is usually a mild, superficial fungal infection caused by the genus Candida. It usually infects the nails (onychomycosis); skin (diaper rash); mucous membranes, especially the oropharynx (thrush); vagina (moniliasis); esophagus; and GI tract. Invasive candidiasis occurs when a Candida species enters the bloodstream, causing candidemia and then spreading throughout the body to affect the kidneys, liver, lungs, endocardium, brain, or other structures. Candidemia is the fourth most common bloodstream infection among hospitalized patients in the United States. Such systemic infection is most prevalent among drug abusers, patients who are already hospitalized, patients with a central venous catheter, burn victims, very-low-birth-weight babies, diabetics, or immunosuppressed patients. The prognosis varies, depending on the extent of infection. If the invasive form doesn’t respond to treatment, organ failure and death may occur.
Causes
Most cases of Candida infection result from C. albicans. Other infective strains include C. parapsilosis, C. tropicalis, C. glabrata, and C. guilliermondii. These fungi are part of the normal flora of the GI tract, mouth, vagina, and skin. They cause infection when some change in the body (such as rising glucose levels from diabetes mellitus or lowered resistance from an immunosuppressive drug, radiation, aging, or a disease such as cancer or human immunodeficiency virus [HIV] infection) permits their sudden proliferation or when they’re introduced systemically by central venous or urinary catheters, drug abuse, total parenteral nutrition, or surgery.
Complications
The most common complications include Candida dissemination with organ failure of the kidneys, brain, GI tract, eyes, lungs, and heart.
Assessment Findings
The patient’s history may reveal an underlying illness, such as cancer, diabetes, or HIV infection; antineoplastic therapy; or drug abuse. Symptoms of superficial candidiasis correspond to the site of infection:
Skin—Scaly, erythematous, papular rash, sometimes covered with exudate, appearing below the breast, between the fingers, and at the axillae, groin, and umbilicus; in diaper rash, papules appear at the edges of the rash
Nails—Red, swollen, darkened nail bed; occasionally, purulent discharge and the separation of a pruritic nail from the nail bed
Oropharyngeal mucosa (thrush)—Cream-colored or bluish white curdlike patches of exudate on the tongue, mouth, or pharynx that reveal bloody engorgement when scraped; the areas may swell, causing respiratory distress in infants, or they may be painful or cause a burning sensation in the throat and mouth of adultsRelated posts:
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