Candidiasis
Epidemiology and Etiology:
- Risk factors:
- Diabetes
- Burn patients
- Immunocompromised
- Newborns
Common sites:
- normal location:
- skin, nails
- mouth
- GI tract
- Vagina
- May be disseminated
in immunosuppressed
Gross features:
- Mucous membranes:
- Gray-white,
dirty-looking pseudomembranes
- Mucosal hyperemia
deep to pseudomembrane
- Vaginitis
- Diaper rash
- disseminated:
- renal abscesses
- myocardial
abscesses
- endocarditis
- meningitis
- brain microabscesses
- endophthalmitis
- hepatic
abscesses
- bilateral
nodular lung infiltrates (resembles PCP)
Histologic features:
- yeastlike forms (blastoconidia)
- pseudohyphae (important)
- budding yeast
cells joined end to end simulating true hyphae
- no septae
- true hyphae (less commonly)
- defined by the
presence of septae
- oral cavity:
- “neuts in the horn” – neutrophils in the superficial epidermis (above
granular layer?)
- may see pseudomembranes of matted candida
and inflammatory debris
-
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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GMS
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PAS
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Molecular features:
Other features:
- Candida albicans is most common pathogenic species
- Easily shifts
phenotype in a reversible and random fashion
- Important virulence
factors:
- Adhesins
- Aspartyl
proteinases
- Catalases
(aid intracellular survival and resist oxidative damage)
- Adenosine
(blocks neutrophil oxygen radical production
and degranulation)
- Chronic mucocutaneous candidiasis
- Associated
with T cell defects, endocrinopathies
- Chronic,
refractory
- Mucous
membranes, skin, hair, and nails
References: