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6th July 2023
Superficial Candida Albicans Infection
Candida albicans is a yeast that commonly infects the skin and is a commensal organism in the GI tract. Predisposing factors include extremes of age, opposing skin folds, obesity, diabetes, immunosuppression, use of broad-spectrum antibiotics and humid environments. Diagnosis is clinical but swab samples sent for microscopy can demonstrate budding yeast cells and pseudohyphae. Superficial infection may present in a number of sites:
| Site | Presentation | Management |
|---|---|---|
| Oral | White/red patches or plaque. May be associated with pain on swallowing, glossitis and angular stomatitis. RF: dentures, broad-spectrum antibiotics and use of steroid inhalers. | Consider if the patient is immunosuppressed.
1st line: miconazole gel, if not suitable – nystatin for 7/7 2nd line: PO fluconazole 7/7 |
| Intertrigo | Submammary, axillary, interdigital and inguinal folds. Manifests as itchy red plaques with satellite lesions. | 1st line: topical imidazole (clotrimazole, miconazole, ketoconazole).
2nd line/widespread disease/immunocompromised: PO fluconazole 14/7 |
| Nails | Presents as chronic paronychia. Affects individuals that work in wet environments (e.g. fishermen, gardeners). Red, swollen and tender nail fold with associated nail discolouration and ridging. | 1st line: topical antifungals
2nd line: PO fluconazole |
| Vulvovaginal /penile | Itchy white adherent plaques, cottage cheese-like discharge, inflamed mucus membranes. | 1st line: topical antifungals. Addition of PV clotrimazole in vulvovaginal disease.
2nd line: PO fluconazole |
Table 6: Summary of candida albicans infection and its management
Oral candida albicans infection
Image Source: Wikimedia Commons (2008). Oral thrush Aphthae Candida albicans. PHIL 1217 lores, Licensed under a creative commons licence. Available for free at: https://commons.wikimedia.org/wiki/File:Oral_thrush_Aphthae_Candida_albicans._PHIL_1217_lores.jpg (Accessed on: 10 March 2022).
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