(GP)

Overview

• Most commonly caused by Candida albicans (type of dimorphic fungi)
• Appears almost universally in low numbers on healthy skin, in the oropharyngeal cavity, and in the GI and GU tracts. Causes disease in high risk patients.
• Risk Factors → immunosuppression (HIV, diabetes, steroid use), imbalance in local flora (antibiotic, steroid use), compromised skin
• May be local infection (imbalance in local flora leading to overcrowth of C.albicans) or systemic infection (breach of skin barrier leading to direct invasion of bloodstream)

Making Diagnosis

Clinical Features:

• Oral Thrush → oropharyngeal region affected. White plaque in the oral cavity that can be scraped off, leading to inflamed areas. Cottony feeling in the mouth. Fissuring at mouth corners. May be caused by ICS (beclamethasone) use in asthmatics.
• Oesophageal Candidiasis → AIDS-defining illness. Leads to odynophagia (retrosternal pain on swallowing)
• Vulvovaginitis → vaginal yeast infection
  • ‘Cottage cheese’, non-offensive discharge
  • Vulvitis ⇒ dysuria and dyspareunia
• Systemic Candidiasis → fever, fatigue, skin rash, neurological deficits etc.

Investigations:

• Superficial Smear of Lesion for Microscopy → results indicate positive for Candida hyphae