When the natural balance of the bodys flora is
upset in some way, allowing the commensal Candida to grow and cause infection
Antibiotic use - which suppresses normal flora .
Stress
Hospital - Candida is becoming a common "nosocomial" (hospital acquired) infection.
Underlying disease often leads to severe systemic cases. - conditions such as diabetes and AIDS increase susceptibility
It invades the local mucosa, causing local irritation and itchiness.
In extreme cases, the systemic spread throughout the body.
Often predisposing factors contribute to the development of invasive candidal infections.
The hyphal form of candida is associated with invasive candida infections
SUBTYPES OF CANDIDA
INFECTION
Candida is one fungus that causes a wide range of disease.
Recently has become an important pathogen in hospitals.
Some of the commonest are: -
Common in pregnant women or those taking oral contraceptives and antibiotics. Itching, burning and thick yellow discharge from the vagina
Alleviate symptoms by applying yogurt containing lactobacilli, which are normal inhabitants of the vaginal mucosa and keep Candida in check.
Oral Thrush
Common in newborns - they do not have mouth
microflora of their own to suppress the Candida
During birth, the baby may become infected with candida from the
mothers vagina if she is infected.
White flecks on the mouth and throat are seen.
Resolves when the baby develops microflora.
Can also occur in adults with hormonal problems
Image copyright (c) www.doctorfungus.org and used by permission
Balantitis
Male equivalent of vaginal thrush
Transmitted by sexual intercourse
Blistering, itching and burning vesicles on the penis.
Usually affects uncircumcised males.
Candidal Gut Infection
Associated with prolonged antibiotic use
which suppress bacterial populations
Cutaneous Candidiasis
Occurs in over-moist, damaged skin
Onchomycosis - infects subcutaneous skin due to continuous immersion
in water. Affects digits and nails
Image kindly supplied
by Tom Volk, University of Wisconsin-La Crosse
Intertriginous
Candidiasis
Affects areas of the body that are in close contact with
eachother
Common in axillae, groin and skin folds.
Napkin candidiasis - affecting babies whose nappies are not changed
frequently.
Stomatitis
Inflammation of the buccal (mouth) mucosa
Common Candidal infection affecting
denture-wearers.
The most severe form of candida infection but rare.
Involving spread all around the body via blood and lymph
Always a predisposition - frequently occurs in the late stages of diabetes and cancer.
Possible infection through contaminated IV and catheters
Virulence factors present on Candida contribute to systemic infections
Ability of Candida to adhere to epithelial and mucosal cells contributes to virulence. Dimorphic switch also contributes to development.
Fever and chills unresponsive to therapy.
RISK GROUPS
HIV patients
Women using the contraceptive pill, antibiotics, diabetics - vaginal
thrush
Individuals using antibiotics, bone marror/organ transplants,
postsurgery
Fourth most common cause of nosocomial bloodstream infections.
higher incidence among neonates and African-Americans. Overall, 75% of adult women have had at least one episodeof vaginal thrush in their lifetime
Oral thrush common in HIV.
.Invasive disease in critically ill patients with IV
High risk of death in disseminated and blood infections.
ELISA detects antibodies against Candida
Latex bead agglutination assay
Simple cultures on selective media.
Diagnosis difficult - organism often cuased secondary infections, and is mixed with other organisms
Diagnosis of invasive disease can be difficult - an invasive biopsy may be necessary .
No satisfactory treatment,
Cutaneous lesions treated with topical agents.
Systemic infections treated with itraconazole, amphoteracin B.
ketonazole compounds
Drugs which suppress change of one form to the other e,g, yeast to hyphae stop spread
No further problems with appropriate antifungal therapy.
Also occurs as a nocomial infection associated with catheters
Organisms causing Candidiasis
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