[Candidiasis]

Area of Science:

• Mycology
• Infectious Diseases
• Endocrinology

Background:

• Diabetes mellitus (DM) is often linked to increased susceptibility to fungal infections.
• The relationship between DM and superficial candidiasis, particularly oral candidiasis, is well-established, especially with poor glycemic control.
• However, the association between DM and invasive candidiasis requires further clarification.

Purpose of the Study:

• To differentiate the impact of diabetes mellitus on superficial versus invasive candidiasis.
• To outline the diagnostic criteria for invasive candidiasis.
• To review current treatment strategies and recommended antifungal agents for invasive candidiasis based on Japanese guidelines.

Main Methods:

• Review of existing literature and clinical guidelines concerning candidiasis in diabetic patients.
• Analysis of diagnostic approaches for invasive candidiasis, integrating clinical, laboratory, and microbiological data.
• Examination of treatment paradigms including prophylactic, empiric, and targeted antifungal therapies.

Main Results:

• Poor glycemic control in diabetes mellitus correlates with an elevated risk of superficial candidiasis.
• Invasive candidiasis is not found to be directly related to the presence or control of diabetes mellitus.
• Diagnosis of invasive candidiasis relies on a comprehensive assessment of clinical presentation, laboratory findings, and isolation of Candida species.

Conclusions:

• Diabetes mellitus is a significant risk factor for superficial candidiasis but not invasive candidiasis.
• Effective management of invasive candidiasis necessitates a multi-faceted diagnostic approach.
• First-line treatments include micafungin (MCFG), fluconazole (FLCZ), and amphotericin B (AMPH-B), with alternatives like liposomal amphotericin B (L-AMB), voriconazole (VRCZ), and itraconazole (ITCZ) available.