Infectious Disease Book

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CandidiasisAka: Moniliasis

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

Candidiasis (C0006840)

Definition (MSH)Infection with a fungus of the genus CANDIDA. It is usually a superficial infection of the moist areas of the body and is generally caused by CANDIDA ALBICANS. (Dorland, 27th ed)
Definition (CSP)infection with a fungus of the genus Candida; usually a superficial infection of the moist areas of the body and is generally caused by Candida albicans; includes chronic mucocutaneous candidiasis, cutaneous candidiasis, oral candidiasis (thrush), and monilial vaginitis.
Definition (NCI)A condition in which Candida albicans, a type of yeast, grows out of control in moist skin areas of the body. It is usually a result of a weakened immune system, but can be a side effect of chemotherapy or treatment with antibiotics. Thrush usually affects the mouth (oral thrush); however, rarely, it spreads throughout the entire body.
ConceptsDisease or Syndrome (T047)
ICD9112, 112.9
EnglishCandida infection, Candidiases, Candidiasis, Candidiasis of unspecified site, Candidosis, Infection by Candida species, Monilia infection, Moniliases, Moniliasis, MONILIASIS MONILIA, muguet, Thrush
Spanishcandidiasis, candidosis, infección por especies de Candida, infeccion por especies de Candida, moniliasis
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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