Candidiasis

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It is a fungal infection mainly caused by yeast, Candida albicans. Candidiasis is usually precipitated by prolonged use  of  contraceptive  pills,  AIDS,  pregnancy, diabetes,  prolonged  use  of  antibiotics,  corticosteroid use, and being on immunosuppressive treatment. 

Clinical presentation (depending on the site of infection) 

• Erythematous, moist exudate in the skin folds and accompanying satellite pustules 
• Nail affection leads to painful swelling of the nail bed and folds, with pus discharge and is made worse by contact with water  
• Oral  lesions  are  characterized  by  white,  adherent  mucosal  plaques  in  buccal  cavity including the tongue
• Vaginal candidiasis is characterized by itchy, curd-like whitish vaginal discharge, dysuria and dyspareunia
• Gastrointestinal candidiasis may be associated with painful swallowing (odynophagia). Characteristic lesions are seen on endoscopy.

Pharmacological Treatment  Cutaneous candidiasis 

A: clotrimazole cream (topical) 1% apply 12hourly for 2weeks 

OR 

C: miconazole cream (topical) 2% apply 12hourly for 2weeks   

Oral candidiasis 

A: nystatin oral suspension - gurgle and swallow 6hourly a day 

Newborns: 200,000 – 400,000 units for 24 hours

<2 years old 400,000 – 1,000,000 units for 24 hours

>2 years old 1,000,000 – 2,000,000 Units for 24 hours

OR 

C: miconazole 2% oral gel apply every 8hourly for 7days 

Vaginal candidiasis 

A: clotrimazole vaginal pessaries; insert one at night for 6days 

OR 

C: miconazole vaginal pessaries insert one at night for 3days 

AND (if severe) 

A: fluconazole (PO) 150mg stat 

Gastrointestinal Tract (GIT) candidiasis 

A: fluconazole (PO) 150mg 24hourly for 14days