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Candidiasis
Aka: Candidiasis, Moniliasis
- Etiology
- Candida albicans
- Risk Factors
- Skin maceration
- Immunosuppressed patients
- Advanced Human Immunodeficiency Virus (AIDS)
- Hematologic Malignancy
- Antibiotic use
- Corticosteroid use
- Pregnancy
- Diabetes Mellitus
- Signs: Systemic involvement in immunocompromised patient
- Severe muscle tenderness
- Signs: Mucocutaneous Rash
- Character
- Erythematous Papules
- Pruritic, eroded areas
- Scaling and crusting of lesions
- Normal Distribution (Not Immunocompromised)
- Mouth
- Vagina
- Axillae
- Inguinal folds
- Interdigital surfaces
- Signs: Specific Lesions
- Oral Thrush
- White Plaques firmly adhered to Oral Mucosa
- Cutaneous Candidiasis
- Red, macerated intertriginous areas
- Chronic mucocutaneous Candidiasis
- Circumscribed hyperkeratotic skin lesions
- Dystrophic Nails
- Partial Alopecia
- Oral and vaginal Thrush
- Endocrine organ hypofunction
- Hypoparathyroidism
- Hypothyroidism
- Adrenal Insufficiency
- Gastrointestinal
- Distal esophagus Ulcerations
- Hematogenous (Immunosuppressed)
- Fever
- Malaise
- Retinal abscess
- Pulmonary nodular infiltrate
- Endocarditis
- Labs
- Abscess drainage shows candida mycelia
- Candida Serology titers elevated
- KOH Preparation
- Pseudohyphae
- Management
- Cutaneous
- Nystatin
- Ciclopirox
- Imidazole cream
- Oral Thrush
- Clotrimazole
- One troche dissolve in mouth x5 qd for 7-14 days
- Nystatin suspension
- Swish and swallow 4-6 times per day for 7-14 days
- Fluconazole 100 mg PO qd for 7-14 days
- Esophageal
- Ketoconazole 200-400 mg PO qd for 14-21 days
- Fluconazole 100-200 mg PO/IV qd for 14-21 days
- Amphotericin B 0.3 mg/kg/day for 5-10d
- Indicated for severe cases only
- Bladder
- Irrigate with Amphotericin B 50 mg in 1L x5 days
- Disseminated
- Amphotericin B 0.4-0.5 mg/kg IV qd AND
- Consider Flucytosine 37.5 mg/kg PO qid for 2-3 weeks
- Fluconazole 200 mg PO/IV qd x4 weeks