Candida - Revision history

Aidan at 20:48, 6 February 2026

2026-02-06T20:48:38Z

← Older revision		Revision as of 20:48, 6 February 2026
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	*Risk factors include immunosuppression		*Risk factors include immunosuppression

	===Vulvovaginal Candidiasis===		===[[Vulvovaginal candidiasis\|Vulvovaginal Candidiasis]]===

	*Risk factors include colonization from recent antibiotic use, immunosuppression including diabetes, use of oral contraceptives, and pregnancy		*Risk factors include colonization from recent antibiotic use, immunosuppression including diabetes, use of oral contraceptives, and pregnancy
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	* [[Candidemia]]: [[fluconazole]] 12 mg/kg IV load followed by 6 mg/kg PO/IV daily		* [[Candidemia]]: [[fluconazole]] 12 mg/kg IV load followed by 6 mg/kg PO/IV daily
	** Can use [[fluconazole]] 800 mg daily for isolates that show dose-dependent susceptibility		** Can use [[fluconazole]] 800 mg daily for isolates that show dose-dependent susceptibility
	*[[Vaginal candidiasis]]: [[fluconazole]] 150 mg PO once, with or without intravaginal [[clotrimazole]]		*[[Vulvovaginal candidiasis\|Vaginal candidiasis]]: [[fluconazole]] 150 mg PO once, with or without intravaginal [[clotrimazole]]
	*[[Oral thrush]]: [[fluconazole]] 100 mg po daily for 7 to 14 days		*[[Oral thrush]]: [[fluconazole]] 100 mg po daily for 7 to 14 days
	*[[Esophageal candidiasis]]: [[fluconazole]] 200 mg PO daily for 14 to 21 days		*[[Esophageal candidiasis]]: [[fluconazole]] 200 mg PO daily for 14 to 21 days

Aidan: /* Investigations */

2025-10-08T15:48:39Z

Investigations

← Older revision		Revision as of 15:48, 8 October 2025
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	*Blood culture		*Blood culture
	**'''Never ignore candidemia!'''		**'''Never ignore candidemia!'''
	**~~Requires~~ an '''ophthalmology''' consult to rule out endophthalmitis (1-3% of cases)		**If visual symptoms, arrange a non-urgent '''ophthalmology''' consult to rule out endophthalmitis (1-3% of cases)
	**Echocardiogram if IVDU or prosthetic valve		**Echocardiogram if IVDU or prosthetic valve
	*Germ tube test (GTT)		*Germ tube test (GTT)

Aidan: /* Fluconazole Susceptibility */

2023-09-15T14:18:20Z

Fluconazole Susceptibility

← Older revision		Revision as of 14:18, 15 September 2023
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	!Species!!Resistance pattern		!Species!!Resistance pattern
	\|-		\|-
	\|[[Candida albicans]]\|\|Generally fluconazole-susceptible		\|[[Candida albicans]]\|\| rowspan="4" \|Generally [[fluconazole]] susceptible
	\|-		\|-
	\|[[Candida dubliniensis]]~~\|\|Generally fluconazole-susceptible~~		\|[[Candida dubliniensis]]
	\|-		\|-
	\|[[Candida parapsilosis]]~~\|\|Generally fluconazole-susceptible~~		\|[[Candida parapsilosis]]
	\|-		\|-
			\|[[Candida tropicalis]]
	\|[[Candida glabrata]]\|\|Often '''fluconazole resistant''', or dose-dependent
	\|-		\|-
	\|[[Candida ~~tropicalis~~]]\|\|~~Generally~~ fluconazole-susceptible		\|[[Candida glabrata]]\|\|Often '''[[fluconazole]] resistant''', or dose-dependent susceptible
	\|-		\|-
	\|[[Candida krusei]]\|\|Inherent '''fluconazole resistance'''		\|[[Candida krusei]]\|\|Inherent '''[[fluconazole]] resistance'''
	\|-		\|-
	\|[[Candida lusitaniae]]\|\|Often '''amphotericin resistant''' but fluconazole-susceptible		\|[[Candida lusitaniae]]\|\|Often '''[[amphotericin]] resistant''' but [[fluconazole]] susceptible
	\|}		\|}

Aidan: added note on bone and joint infection

2022-09-07T15:17:02Z

added note on bone and joint infection

← Older revision		Revision as of 15:17, 7 September 2022
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	==Management==		==Management==

⚫	*Superficial infections involving skin or mucosa can be treated with either topical preparations or low-dose oral fluconazole
	*Invasive infections should be treated with an echinocandin until species and susceptibilities are available		*Invasive infections should be treated with an echinocandin until species and susceptibilities are available
⚫	**See ~~also~~ [[Candidemia#Management\|management of candidemia]]

			=== Management by Site of Infection ===
		⚫	*Superficial infections involving skin or mucosa: can be treated with either topical preparations or low-dose oral fluconazole
		⚫	*Candidemia: see [[Candidemia#Management\|management of candidemia]]
			*Bone and joint infections
			**Osteomyelitis: likely needs surgical debridement and removal of any implants. Duration of antifungals not well studied, but likely 3 to 12 months
			**Septic arthritis: needs drainage and removal of implants. Duration of antifungals at least 6 weeks.

			=== Fluconazole Susceptibility ===
	{\| class="wikitable"		{\| class="wikitable"
	!Species!!Resistance pattern		!Species!!Resistance pattern

Aidan at 16:41, 25 January 2022

2022-01-25T16:41:45Z

← Older revision		Revision as of 16:41, 25 January 2022
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	* ESCMID guideline for the diagnosis and management of ''Candida'' diseases 2012: non‐neutropenic adult patients. ''Clin Microbiol Infect''. 2012;18(Suppl. 7):19-37. doi: [https://doi.org/10.1111/1469-0691.12039 10.1111/1469-0691.12039]		* ESCMID guideline for the diagnosis and management of ''Candida'' diseases 2012: non‐neutropenic adult patients. ''Clin Microbiol Infect''. 2012;18(Suppl. 7):19-37. doi: [https://doi.org/10.1111/1469-0691.12039 10.1111/1469-0691.12039]
	* Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. ''Clin Infect Dis''. 2016;62(4):e1-50: doi: [https://doi.org/10.1093/cid/civ933 10.1093/cid/civ933]		* Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. ''Clin Infect Dis''. 2016;62(4):e1-50: doi: [https://doi.org/10.1093/cid/civ933 10.1093/cid/civ933]
	{{DISPLAYTITLE:''Candida'' ~~species~~}}		{{DISPLAYTITLE:''Candida''}}
	[[Category:Yeasts]]		[[Category:Yeasts]]

Aidan: Aidan moved page Candida species to Candida without leaving a redirect

2022-01-25T16:41:32Z

Aidan moved page Candida species to Candida without leaving a redirect

← Older revision		Revision as of 16:41, 25 January 2022
(No difference)

Aidan: /* Management */

2021-11-13T00:05:17Z

Management

← Older revision		Revision as of 00:05, 13 November 2021
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	*See also [[Antifungal spectrum of activity]] and [https://doi.org/10.1086/504492 Pharmacology of Systemic Antifungal Agents, CID 2006]		*See also [[Antifungal spectrum of activity]] and [https://doi.org/10.1086/504492 Pharmacology of Systemic Antifungal Agents, CID 2006]

			=== Fluconazole-Susceptible Isolates ===

			* [[Candidemia]]: [[fluconazole]] 12 mg/kg IV load followed by 6 mg/kg PO/IV daily
			** Can use [[fluconazole]] 800 mg daily for isolates that show dose-dependent susceptibility
			*[[Vaginal candidiasis]]: [[fluconazole]] 150 mg PO once, with or without intravaginal [[clotrimazole]]
			*[[Oral thrush]]: [[fluconazole]] 100 mg po daily for 7 to 14 days
			*[[Esophageal candidiasis]]: [[fluconazole]] 200 mg PO daily for 14 to 21 days
			*[[Urinary tract infection]]: [[fluconazole]] 200 mg po daily for 7 to 14 days
			* [[Intra-abdominal infections\|Intraabdominal infection]]: [[fluconazole]] 400 mg PO daily

	== Further Reading ==		== Further Reading ==

Aidan: /* Management */

2021-02-11T15:17:39Z

Management

← Older revision		Revision as of 15:17, 11 February 2021
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	*See also [[Antifungal spectrum of activity]] and [https://doi.org/10.1086/504492 Pharmacology of Systemic Antifungal Agents, CID 2006]		*See also [[Antifungal spectrum of activity]] and [https://doi.org/10.1086/504492 Pharmacology of Systemic Antifungal Agents, CID 2006]

			== Further Reading ==

			* ESCMID guideline for the diagnosis and management of ''Candida'' diseases 2012: non‐neutropenic adult patients. ''Clin Microbiol Infect''. 2012;18(Suppl. 7):19-37. doi: [https://doi.org/10.1111/1469-0691.12039 10.1111/1469-0691.12039]
			* Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. ''Clin Infect Dis''. 2016;62(4):e1-50: doi: [https://doi.org/10.1093/cid/civ933 10.1093/cid/civ933]
	{{DISPLAYTITLE:''Candida'' species}}		{{DISPLAYTITLE:''Candida'' species}}
	[[Category:Yeasts]]		[[Category:Yeasts]]

Aidan at 16:12, 14 September 2020

2020-09-14T16:12:58Z

← Older revision		Revision as of 16:12, 14 September 2020
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	*Old-school enzymatic tests and assimilation assays.		*Old-school enzymatic tests and assimilation assays.
	*'''Temperature tolerance test''' at 35-37º C, 42º C, and 45º C		*'''Temperature tolerance test''' at 35-37º C, 42º C, and 45º C
	*'''Germ tube test:''' if positive, either ''C. albicans'' or ''C. dubliniensis''		*'''[[Germ tube test]]:''' if positive, either ''C. albicans'' or ''C. dubliniensis''

	{\| class="wikitable"		{\| class="wikitable"

Aidan: /* Identification */

2020-08-26T12:53:25Z

Identification

← Older revision		Revision as of 12:53, 26 August 2020
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	*Species that only rarely cause disease in humans include: [[Candida albidus]], [[Candida catenulate]], [[Candida chiropterorum]], [[Candida ciferrii]], [[Candida famata]], [[Candida haemulonii]], [[Candida humicola]], [[Candida inconspicua]], [[Candida kefyr]], [[Candida lambica]], [[Candida lipolytica]], [[Candida norvegensis]], [[Candida pelliculosa]], [[Candida pintolopesii]], [[Candida pulcherrima]], [[Candida rugosa]], [[Candida utilis]] and [[Candida zeylanoides]]		*Species that only rarely cause disease in humans include: [[Candida albidus]], [[Candida catenulate]], [[Candida chiropterorum]], [[Candida ciferrii]], [[Candida famata]], [[Candida haemulonii]], [[Candida humicola]], [[Candida inconspicua]], [[Candida kefyr]], [[Candida lambica]], [[Candida lipolytica]], [[Candida norvegensis]], [[Candida pelliculosa]], [[Candida pintolopesii]], [[Candida pulcherrima]], [[Candida rugosa]], [[Candida utilis]] and [[Candida zeylanoides]]

	==== Identification ====		====Identification====

	*Any yeast that has growth on culture (blood, fluid, tissue) or seen on Gram stain gets subcultured to SAB-CG at 35º C.		*Any yeast that has growth on culture (blood, fluid, tissue) or seen on Gram stain gets subcultured to SAB-CG at 35º C.
		⚫	*Do wet mount to confirm features of ''Candida.''
	**Growth rate: <7 days is rapid
	**Texture
	**Colour of surface and reverse
⚫	*Do wet mount to confirm features of ''Candida''.
	*'''Microscopy''' for chlamydospores, pseudohyphae, hyphae, arthroconidia, blastoconidia formation, budding, capsules, pigmentation.		*'''Microscopy''' for chlamydospores, pseudohyphae, hyphae, arthroconidia, blastoconidia formation, budding, capsules, pigmentation.
	**''C. glabrata'' is smaller, does not produce hyphae or pseudohyphae, produces blastoconidia, and grows as creamy yeast colonies.		**''C. glabrata'' is smaller, does not produce hyphae or pseudohyphae, produces blastoconidia, and grows as creamy yeast colonies.
	**Non-glabrata spp. usually exhibit single buddings and can have pseudohyphae (rarely true septate hyphae). Cannot identify species based on microscopy alone.		**Non-glabrata spp. usually exhibit single buddings and can have pseudohyphae (rarely true septate hyphae). Cannot identify species based on microscopy alone.
	*'''MALDI-ToF''' (Vitek MS)~~, which~~ provides a species. If ''C. haemolunii'' or ''C. famata'' identified on Vitek, need to rule out ''C. auris''.		*'''MALDI-ToF''' (Vitek MS) provides a species. If ''C. haemolunii'' or ''C. famata'' identified on Vitek, need to rule out ''C. auris''.
	**If Vitek not ≥95% match, or identifies one of the two species above, then repeat the MALDI-ToF and set up Dalmau on cornmeal agar.		**If Vitek not ≥95% match, or identifies one of the two species above, then repeat the MALDI-ToF and set up Dalmau on cornmeal agar.
	*'''Dalmau technique:''' growth in adverse conditions (bile oxgall and corn meal) to help identify differences between species of yeast.		*'''Dalmau technique:''' growth in adverse conditions (bile oxgall and corn meal) to help identify differences between species of yeast.
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	\|}		\|}

	=== Epidemiology ===		===Epidemiology===

	*Refer to [https://doi.org/10.1093/cid/cis697 Cleveland et al; CID 2012 55:1352].		*Refer to [https://doi.org/10.1093/cid/cis697 Cleveland et al; CID 2012 55:1352].