Kandidoos

Kandidoos, or candidiasis, is an infection caused by yeasts of the genus Candida, most commonly Candida albicans. Candida species are part of the normal microbiota of the human mucosa and skin; infection occurs when balance is disrupted or immunity is compromised.

Clinical forms range from localized mucocutaneous infections to invasive disease. Mucocutaneous candidiasis includes oral thrush, esophagitis, vulvovaginal candidiasis, balanitis, diaper rash, and intertriginous dermatitis. Invasive candidiasis refers to dissemination of Candida to the bloodstream and organs, and carries greater morbidity and mortality, particularly in hospitalized or immunocompromised patients.

Risk factors include recent broad-spectrum antibiotic use, diabetes, immunosuppression (HIV/AIDS, chemotherapy, steroids), neutropenia, premature birth, indwelling devices (central venous catheters), and hospitalization.

Diagnosis is based on clinical suspicion supported by laboratory tests. Microscopy (KOH mount) and culture of affected sites are standard; histopathology can confirm invasion. Blood cultures are used for suspected candidemia; nonculture tests such as beta-D-glucan may aid in diagnosis. Species identification guides treatment choices due to variable antifungal susceptibility.

Treatment depends on site and severity. Localized mucocutaneous infections are usually treated with topical azoles or nystatin. Oropharyngeal or esophageal candidiasis, and vaginal candidiasis may respond to systemic or topical azoles; fluconazole is commonly used. Invasive disease typically requires intravenous antifungals, commonly an echinocandin (caspofungin, micafungin, anidulafungin) initially, with step-down to fluconazole if the isolate is susceptible. Alternatives include liposomal amphotericin B. Antifungal resistance, particularly with Candida glabrata, Candida krusei, and Candida auris, is an important concern.

Prevention focuses on controlling risk factors, maintaining good mucosal health, careful use of antibiotics, and stringent infection control in healthcare settings to reduce outbreaks.