candidal

Candidal is an adjective relating to Candida, a genus of yeasts that are part of the normal human microbiota. The most common disease-causing species is Candida albicans, but other species such as C. glabrata, C. tropicalis, and C. parapsilosis can cause infections. Candidal infections range from superficial mucocutaneous conditions to invasive diseases that may be life-threatening, especially in immunocompromised individuals, hospitalized patients, or those with implanted devices.

Superficial candidal infections include oropharyngeal candidiasis (thrush), esophageal candidiasis, vulvovaginal candidiasis, intertrigo and diaper dermatitis. Balanitis and denture stomatitis are also seen. Invasive candidiasis occurs when Candida enters the bloodstream or deep tissues (candidemia), often after surgery, in patients with central venous catheters, or in those with neutropenia or critical illness.

Candida pathogenicity is aided by adherence to surfaces, biofilm formation, production of hydrolytic enzymes, and morphological switching between yeast and hyphal forms. Disruption of normal flora, antibiotic use, diabetes, corticosteroid use, or immunosuppression increases risk.

Diagnosis relies on clinical suspicion supported by microbiology. Microscopy and culture of affected sites show yeasts with budding or pseudohyphae. Culture on standard media, such as Sabouraud dextrose agar, confirms species. In invasive disease, blood cultures, imaging, and nonculture tests like beta-D-glucan or Candida PCR can aid but have limitations.

Treatment depends on infection site and severity. Superficial candidiasis is treated with topical azoles or allylamines; vaginal candidiasis often responds to fluconazole. Invasive disease requires systemic antifungals such as an echinocandin (for example caspofungin or micafungin), followed by oral fluconazole when appropriate. Amphotericin B is used in selected cases. Remove infected catheters when possible and manage risk factors.

Prevention focuses on infection control, prudent antibiotic stewardship, and management of risk factors in high-risk patients. Candida colonization is common; in select intensive care or hematologic patients, antifungal prophylaxis may be used to reduce invasive candidiasis.