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Candidiasis: pathogenesis, clinical characteristics, and treatment
1Loma Linda University School of Dentistry, USA. sappleton@sd.llu.edu
Abstract:
Candida organisms live on the skin and mucous membranes of up to 75 percent of the population. They can live commensally without causing harm or can change to an aggressive form and invade tissue, causing both acute and chronic disease in the host. Oropharyngeal candidiasis manifests clinically as acute pseudomembranous, acute atrophic, chronic atrophic, chronic hypertrophic/hyperplastic, and angular cheilitis. Systemic infection leading to candidemia can be devastating and cause up to a 60 percent mortality rate in medical or post-surgical intensive care wards. Oral nystatin, clotrimazole, and fluconazole usually provide appropriate therapy; although resistance to medications is increasing, particularly in immunocompromised hosts.
Insights
Candida yeasts commonly colonize humans but can cause serious infections, including oral thrush and life-threatening candidemia. Antifungal resistance is a growing concern, especially in vulnerable patients.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Medicine
Background:
- Candida species are common commensal organisms in humans, residing on skin and mucous membranes.
- These fungi can transition from harmless colonization to aggressive pathogens, causing acute and chronic diseases.
- Oropharyngeal candidiasis presents in various clinical forms, while systemic candidemia carries a high mortality rate.
Purpose of the Study:
- To review the clinical manifestations of Candida infections.
- To discuss current therapeutic options for oropharyngeal candidiasis and candidemia.
- To highlight the emerging challenge of antifungal resistance.
Main Methods:
- Literature review of Candida pathogenesis, clinical presentations, and treatment.
- Analysis of epidemiological data regarding Candida colonization and infection rates.
- Examination of current antifungal treatment guidelines and resistance patterns.
Main Results:
- Candida infections range from superficial oral thrush to invasive candidemia with significant mortality.
- Common oral presentations include pseudomembranous, atrophic, and hyperplastic forms.
- Antifungal drugs like nystatin, clotrimazole, and fluconazole are standard treatments, but resistance is increasing.
Conclusions:
- Candida infections pose a significant health burden, necessitating effective management strategies.
- The rise in antifungal resistance, particularly in immunocompromised individuals, requires ongoing monitoring and research.
- Development of novel therapeutic approaches may be crucial to combat resistant Candida strains.