CANDIDIASIS

• Candidiasis


  Superficial fungal infection that usually infects the skin, nails, mucous membrane, vagina, esophagus and GI tract
• CS

  Candidiasis other terms: Candidosis / Moniliasis
• Candidiasis etiologic agent:

  Candida albicans
• Sources of infection: Candida are part of the normal flora of the GI tract, mouth, vagina and skin. They cause infection when some changes in the body (such as increased blood glucose or immunocompromised) occurs.
• Clinical Manifestations


  • Skin
  • Nails
  • Oropharyngeal mucosa (thrush)
  • Esophageal mucosa
  • Vaginal mucosa
  • Lungs
  • Kidney
  • Brain
  • Endocardium
  • Eye
• Skin


  • Scaly, erythematous, popular rash, sometimes covered with exudates, appearing below the breast, between the fingers, and the axillae, groin, and umbilicus
• Nails


  • Red, swollen, darkened nail bed
  • Occasionally, purulent discharge and the separation of a pruritic nail from the nail bed
• Oropharyngeal mucosa (thrush)


  • Cream-colored or bluish white curd-like patches of exudates on the tongue, mouth, or pharynx that reveal bloody engorgement when scraped
• Esophageal mucosa


  • Dysphagia
  • Retrosternal pain, regurgitation
  • Occasionally, scales in the mouth and throat
• Vaginal mucosa


  • White or yellow discharge, with pruritus and local excoriation
  • White or gray raised patches on vaginal walls, with local inflammation
  • Dyspareunia
• Lungs


  • Hemoptysis, cough, fever
• Kidney


  • Fever, flank pain, dysuria, hematuria, pyuria, cloudy urine
• Brain


  • Headache, nuchal rigidity, seizures, focal neurologic deficits
• Endocardium


  • Systolic or diastolic murmur, fever, chest pain, embolic phenomena
• Eye


  • Endophthalmitis, blurred vision, orbital or periorbital pain, scotoma, exudates
• Diagnostic Procedures


  • Blood Culture
  • Culture of vaginal scraping
  • Echocardiography if here is cardiac involvement
  • Fundoscopy for patients with endophthalmitis
• Diagnostic Tests


  • Enzyme linked Immuno-Sorbent Assay (ELISA) - presumptive test
  • Western Blot-confirmatory test
  • Particle agglutination (PA)
  • Immunofluorescent Test
• Treatment Modalities


  • Antifungal: Nystatin, Clotrimazole, Miconazole
  • Reverse transcriptase inhibitors (Zidovudine)
  • Protease inhibitors (Ritonavir)
• Nursing Management


  • Avoid accidental wounds from infectious materials used in HIV patients
  • Avoid contact of open skin lesions
  • Gloves should be worn when handling blood specimens
  • Handwashing
  • Blood and other specimens should be labelled prominently
  • Instruments with lenses should be sterilized after use on AIDS patient
  • Needles should not be bent after use, placed it under puncture-resistant
  • Patients with active Aids should be isolated
  • Care of thermometer - wash with warm soapy water, Soak in 70% alcohol for 10 minutes, dry and store