From Oral Candidiasis to Candidemia: A Review of Superficial to Invasive Progression

Area of Science:

• Mycology
• Infectious Diseases
• Oral Medicine

Background:

• Oral candidiasis is a common fungal infection, frequently seen in immunocompromised individuals.
• It is increasingly recognized that oral Candida species can lead to invasive candidiasis, such as candidemia, a significant cause of hospital-acquired infections with high mortality rates.
• Non-albicans Candida species are emerging as important pathogens in both oral and invasive infections.

Purpose of the Study:

• To review the clinical aspects of oral candidiasis and its association with invasive candidemia.
• To discuss local and systemic risk factors contributing to the progression of oral candidiasis.
• To explore the role of non-albicans Candida species, antifungal resistance, and the oral microbiome in candidiasis and candidemia pathogenesis.

Main Methods:

• This review synthesizes current scientific literature on oral candidiasis and candidemia.
• It examines clinical manifestations, risk factors, and etiological agents.
• Relevant animal models for studying virulence and therapeutic strategies are also considered.

Main Results:

• Growing evidence links oral Candida infections to invasive candidemia, especially in susceptible hosts.
• Non-albicans Candida species play an increasing role in the pathogenesis of both conditions.
• Antifungal resistance and interactions with the oral microbiome are critical factors influencing disease progression.

Conclusions:

• Early diagnosis and prevention of oral candidiasis are crucial to reduce the risk of invasive candidemia.
• Understanding the interplay between oral Candida, the microbiome, and host factors is essential.
• Developing alternative therapies is imperative due to rising antifungal resistance.