[Candida and the gastrointestinal tract. A medical-research evaluation]

In immunocompetent persons, Candida species are members of the normal flora of the gastrointestinal tract. Budding yeasts, in particular Candida albicans, can, however, in patients with a corresponding disposition, spread topically and systemically, that is, they may become pathogenic. In hematological/oncological patients with severe immunodeficiency, for example, the mycelium may infiltrate the muscularis mucosae, with involvement also of the vascular system. The relationships between recurrent diarrhea and Candida are still discussed controversial; various data do, however, suggest that massive colonization with Candida might well represent a(n additional) diarrhea-provoking factor. Similar considerations may also be assumed to apply to diarrhea induced by antibiotic therapy. For immunocompetent persons, guidelines exist for the yeast cell count in the stools. The interpretation of quantitative findings must, however, always be made on an individual basis and against the background of clinical symptoms and/or any particular predisposition of the patient. Reliable treatment of superficial candidasis can be achieved with oral polyene antifungal antibiotics (nystatin, amphotericin B).