CANDIDIASIS – Clinical Manifestations and

lab diagnosis of Oral Candidiasis

CONTENTS TO STUDY

•Clinical manifestations of candida•Lab diagnosis of oral candidiasis

Clinical Manifestations of CandidaC

an

did

iasi

s

Infectious diseases

Mucocutaneous

manifestationsCutaneous

manifestations

Systemic manifestation

s

Allergic diseases

Mucocutaneous Manifestations

Mu

cocu

tan

eou

s m

an

ifest

ati

on

s

Oral candidiasis

Angular cheilitis

Oesophagitis

Vulvovaginitis, Balanitis,

BalanoposthitisChronic

mucocutaneous candidiasis

(CMC)

Ocular candidiasis

Cutaneous Manifestations

Cu

tan

eou

s M

an

ifest

ati

on

sIntertrigo

Paronychia and Onychomycosis

Diaper dermatitis

Candidial granuloma

Systemic Manifestations

Systemic manifestations

Urinary tract candidiasis

Candiduria

Endocarditis

Pulmonary candidiasis

Meningitis

Candidemia and Septicemia

Disseminated candidiasis

Arthritis

Osteomyelitis

Endopthalmitis

Nosocomial candidiasis

Allergic Diseases

All

erg

ic d

isease

s Candidids

Eczema

Asthma

Gastritis

Lab diagnosis of Oral Candidiasis

Samples• Whitish patches from mucous membrane of mouth• Sputum

Method of collection• Sterile swabs

Direct examination (Microscopy)• KOH wet mount • Gram staining ( Presence of yeast cells and

pseudohyphae) • Other stains: PAS and Gomori’s methenamine silver

stain

Lab diagnosis continued…Fungal culture• Sabouraud Dextrose Agar + Antibiotics ( Cream, Pasty, Smooth colonies in 3-4 days of incubation at 37 C)

• Cornmeal Agar (Characteristic terminal chlamydospores, yeast cells and pseudohyphae in clusters at 25 C)

• CHROMagar (light green to bluish green colonies)

Germ tube test (Reynold’s-Braude Phenomenon)• Culture of candida treated with sheep/normal human serum is incubated at 37 C for 2-4 hours

• No constriction seen at the point of attachment to the yeast cell• Appear in 2 hours for C.albicans

Chlamydospore formation• Suspected strain of Candida isolates gron on CMA or rice starch agar and incubated at 25 C

• Formation of large, highly refractile, thick walled, terminal chlamydospores in 2-3 days of incubation

Lab diagnosis continued…

Biochemical tests• Glucose and Maltose fermented with acid and

gas production, sucrose and lactose not fermented.

• Pale pink coloration in Tetrazolium reduction medium

Typing of Candida strains• Tests include serotyping and isoenzyme profiling• RFLP and Southern blotting technique used

Immunodiagnosis• PCR based tests for candida-DNA detection• Detection of Candida albican-derived molecules• ELISA, RIA, CIE, PHA and LPA

Lab diagnosis continued…

Detection of metabolites• Detection of D-mannose and D-arabinitol in sera by

gas liquid chromatography• G-test for detection of glucan

Skin tests• Testing delayed hypersensitivity to candidial

antigens

Animal Pathogenicity• Tests on rabbits and mice for susceptibility to

different candidia species

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