CANDIDIASIS

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CANDIDIASIS

An infection usually confined to the mucous membranes and external layers of the skin

Causes

• Candida albicans, transmitted by direct contact

Clinical features

It may present as:

• Oral thrush

• Intertrigo

• Vulvo vaginitis

• Paronychia (nail infection)

• GIT candidiasis may present with pain on swallowing, vomiting, diarrhoea, epigastrium and

retrosternal pain

Investigations

Diagnosis is mainly clinical

Smear examination with KOH preparations

Management

Oral candidiasis

all ages: apply gentian violet 0.5% paint

twice daily for 5 days or

adults: nystatin tablets 500,000−1,000,000 IU

every 6 hours for 10 days (chewed then swallowed)

child <5yrs: nystatin oral suspension 100,000 IU as above; 5−12yrs: 200,000 IU per dose

or ketoconazole 200mg daily for 5 days or,Fluconazole 150mg single dose

Vaginal candidiasis

Avoid sexual activity while on treatment

Apply gentian violet 1% paint onto the vagina once daily for 3 days

or insert one nystatin pessary 100,000 IU each night for 10 days

or ketoconazole 400mg every 12 hrs for 5 days or,Fluconazole 150mg single dose

or,clotrimazole 1% vaginal cream apply 12 hrly for 5 days

Paronychia

griseofulvin 500mg daily for 6 months

or until the nail appears normal

Intertrigo

griseofulvin 500mg daily for 2−4 weeks

Prevention

• Early detection and treatment

• Vaginal candidiasis: avoid unprotected sex