Candidiasis Đánh giá ban đầu

Cutaneous Candidiasis

The signs and symptoms of cutaneous candidiasis include erythematous papules or macules that may be confluent, very pruritic, frequently pustular with distinct border, and sometimes accompanied by creamy white exudate or scaling. Cutaneous candidiasis usually occurs in warm moist places (eg inguinal, axillary and intergluteal regions).

Paronychia and Onychomycosis

The signs and symptoms of paronychia include well-localized area of inflammation that becomes warm and bright red accompanied by pain due to swelling of proximal and lateral nailfolds and may extend extensively under the nail that usually occurs in persons who frequently immerse hands in the water. Purulent material under the cuticle may also be seen. In chronic cases, cuticle separates from the nail plate which leaves a space between proximal nailfold and nail plate exposed to infection.

The signs and symptoms of onychomycosis include discolored nails. They may also appear thickened with splitting and roughening with occasional nail loss.

Please see Tinea Unguium disease management chart for further information.

Mucosal Candidiasis

Oropharyngeal (Thrush)

Candidiasis_Initial Assesment 2

The signs and symptoms of thrush are creamy white, curd-like patches on the tongue and other oral mucosal surfaces, loss of taste, pain on eating/swallowing, and cottony feeling in the mouth. The risk factors for thrush include denture use, history of treatment with antibiotics, chemotherapy or radiation therapy, inhaled glucocorticoids for asthma or rhinitis, immunosuppression, and patients with xerostomia. 

Esophageal

The symptoms of esophageal candidiasis include painful swallowing, a feeling of obstruction on swallowing, retrosternal chest pain, and nausea and vomiting. This is commonly seen in immunocompromised patients and those with hematologic malignancies.

Intra-abdominal

Intra-abdominal candidiasis occurs in patients that have had recent abdominal surgery or intra-abdominal events referring to a heterogeneous group of infections that includes peritonitis, abdominal abscess and purulent or necrotic infection at sites of gastrointestinal perforation or anastomotic leak. The most prominent symptom is abdominal pain, a symptom of gastritis.

Vulvovaginal

Vulvovaginal candidiasis is common in diabetic and immunocompromised patients, patients on hormone replacement therapy, postpubertal females, and females in childbearing age and postmenopausal women. The symptoms of vulvovaginal candidiasis include vaginal discomfort, vulvar pruritus, burning sensation in vaginal area, curd-like discharge, erythematous and swollen labia, erythematous with white plaques vaginal walls, and occasional dysuria and dyspareunia.

Please see Vaginitis: Trichomoniasis, Candidiasis, Bacterial Vaginosis disease management chart for further information.

Chronic Mucocutaneous Candidiasis

Chronic mucocutaneous candidiasis is a group of disorders that includes Candida infections of the skin, mucous membranes, hair and nails characterized by a protracted and persistent course despite what is usually adequate therapy. Signs of mucocutaneous candidiasis include alopecia, esophageal stenosis, and disfiguring lesions of the face, scalp, hands and nail. 

A detailed patient history and thorough physical examination is strongly recommended as part of the diagnosis of candidiasis.