Candida species
From IDWiki
Background
- Most common medically-important genus of yeast
Microbiology
- Budding yeast
- Human pathogens include:
- 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
Clinical Manifestations
- Most common: infections of the mouth, vagina, skin
- In immunocompromised, ICU, IVDU, or TPN patients: esophageal candidiasis, candidemia, CNS infection, endophthalmitis
- Less common: septic arthritis
- IVDU: endocarditis
Investigations
- Urine culture if concern for cystitis
- Blood culture
- Never ignore candidemia!
- Requires an ophthalmology consult to rule out endophthalmitis (1-3% of cases)
- Echocardiogram if IVDU or prosthetic valve
- Germ tube test (GTT)
- If positive, indicates Candida albicans or Candida dubliniensis
- Identifies fluconazole-sensitive Candidae
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
- See also management of candidemia
| Species | Resistance pattern |
|---|---|
| Candida albicans | Generally fluconazole-susceptible |
| Candida dubliniensis | Generally fluconazole-susceptible |
| Candida parapsilosis | Generally fluconazole-susceptible |
| Candida glabrata | Often fluconazole resistant, or dose-dependent |
| Candida tropicalis | Generally fluconazole-susceptible |
| Candida krusei | Inherent fluconazole resistance |
| Candida lusitaniae | Often amphotericin resistant but fluconazole-susceptible |
