Treatment Guideline Chart
Candida sp are the most common cause of fungal infections.
 It can cause infections that range from benign mucocutaneous illnesses to invasive process that may affect any organ.
 It is considered as normal flora in the gastrointestinal and genitourinary tracts, but when there is an imbalance in the ecological niche, they can invade and cause disease.
Most common risk factors include broad-spectrum antibiotic use, central venous catheter use, receipt of parenteral nutrition, receipt of renal placement therapy by patients in ICUs, neutropenia, implantable prosthetic device use and receipt of immunosuppressive agents.

Candidiasis Signs and Symptoms


  • Infections caused by Candida sp are major causes of morbidity and mortality causing diverse spectrum of clinical disease that ranges from superficial and mucosal infections to invasive disease associated with candidemia and metastatic organ involvement
  • Candida albicans is the causative organism of mucocutaneous candidiasis
    • Non-albicans species such as Candida glabrata, Candida krusei and Candida tropicalis have also been identified
  • Most common pathogens of invasive candidiasis are C albicans, C glabrata, C tropicalis, Candida parapsilosis, C krusei
    • Please see Invasive Candidiasis disease management chart for further information

Signs and Symptoms

Cutaneous Candidiasis
  • Signs and symptoms: Erythematous papules or macules that may be confluent, very pruritic, frequently pustular with distinct border and sometimes accompanied by creamy white exudate or scaling
  • Usually occurs in warm moist places (eg inguinal, axillary and intergluteal regions)
Paronychia and Onychomycosis
  • Signs and symptoms of paronychia: 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 be seen
    • In chronic cases, cuticle separates from the nail plate which leaves a space between proximal nailfold and nail plate exposed to infection
  • Signs and symptoms of onychomycosis: Nail appears discolored and thickened with splitting and roughening with occasional nail loss
Mucosal Candidiasis
Oropharyngeal (Thrush)
  • Signs and symptoms: Creamy white, curd-like patches on the tongue and other oral mucosal surfaces, loss of taste, pain on eating/swallowing, cottony feeling in the mouth
  • Risk factors include denture use, history of treatment with antibiotics, chemotherapy or radiation therapy, inhaled glucocorticoids for asthma or rhinitis, immunosuppression, patients with xerostomia


  • Symptoms: Painful swallowing, a feeling of obstruction on swallowing, substernal chest pain, nausea and vomiting
  • Commonly seen in immunocompromised patients and those with hematologic malignancies
  • Occur in patients that have had recent abdominal surgery or intra-abdominal events referring to a heterogenous group of infections that includes peritonitis, abdominal abscess and purulent or necrotic infection at sites of gastrointestinal perforation or anatomic leak
  • Symptoms: Abdominal pain (symptoms of gastritis)
  • Common in diabetic and immunocompromised patients, patients on hormone replacement therapy, postpubertal females, females in childbearing age and postmenopausal women
  • Symptoms: Vaginal discomfort, vulvar pruritus, burning sensation in vaginal area, curdlike discharge, erythematous and swollen labia, erythematous with white plaques vaginal walls, occasional dysuria and dyspareunia
  • Please see Vaginitis: Trichomoniasis, Candidiasis, Bacterial Vaginosis disease management chart for further information
Chronic Mucocutaneous Candidiasis
  • 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: Alopecia, esophageal stenosis, disfiguring lesions of the face, scalp, hands and nail
Editor's Recommendations
Special Reports