Candidiasis

Pathophysiology

C. albicans normally lives in balanced symbiosis with other internal flora
When natural bacterial flora is suppressed (most commonly by antibiotic use), candida converts from benign to aggressive form
Usually limited to skin and mucous membranes. Can invade the bloodstream (candidemia) and colonize internal organs in immunocompromised individuals
Hospital settings pose particular risk through catheters, ports, or open wounds

Oral thrush: White, "cheesy" or curd-like patches on tongue or inner cheek that rub off to reveal a raw, red, or bleeding base
Vulvovaginitis: Cottage cheese-like discharge with yeasty odor. Intense itching
Intertrigo: Red, flaky rashes with fissures in warm, moist skin folds (groin, axilla, breasts)
Angular cheilitis: Painful fissures at corners of the mouth
Systemic signs: Drug-resistant fever, chills, fatigue (indicates internal invasion)

Candidiasis in an otherwise healthy adult: May indicate undiagnosed immunocompromising condition (HIV, diabetes)
Systemic candidemia (organ failure, high fever, disorientation): Life-threatening — emergency referral
Thrush patches rubbing off to reveal raw, bleeding base: Distinguishes candidiasis from other white oral lesions
KOH preparation: Medical gold standard for confirming fungal infection

Hygiene protocol: Fungal infections can be contagious. Strict hygiene and avoid direct contact with lesions
Local contraindication: Active lesions (thrush, intertrigo, vulvovaginitis) — avoid direct contact
Not contagious through casual skin contact in mild cases, but severe cutaneous candidiasis may indicate serious immune impairment
Systemic contraindication if febrile or showing signs of systemic invasion
Referral trigger: Persistent unexplained fatigue and recurrent candidiasis may warrant medical investigation

Thrush patches rubbing off to reveal raw, bleeding base distinguish candidiasis from other oral lesions
Candidiasis in an otherwise healthy adult should raise suspicion for undiagnosed immunocompromise
KOH preparation is the gold standard for confirming fungal infection
Systemic candidemia is life-threatening and requires emergency referral

Candidiasis is an opportunistic infection triggered primarily by antibiotic suppression of normal bacterial flora
Oral thrush and vulvovaginitis are the most recognizable presentations
Severe candidiasis in an otherwise healthy adult should raise suspicion for undiagnosed immunocompromise
Systemic candidemia is life-threatening and requires emergency referral
Strict hygiene. Avoid direct contact with active lesions