Imaging in candidiasis

Abstract

ANDIDA IS A ubiquitous fungus commonly found in the normal flora of the mouth, oropharynx, intestines, vagina, and skin. The mouth, esophagus, lungs, and urinary tract are frequent sites of local infections. 1 Systematic candidiasis is defined as an invasive infection involving the parenchyma of two or more visceral organs excluding the mucosa of the gastrointestinal, respiratory, or genitourinary tracts. 2 Most infections are caused by Candida albicans and Candida tropicalis. 3 The review will emphasize hematogenously disseminated disease. Hematogenously disseminated candidiasis most often occurs in patients who are immunocompromised or debilitated, have been subjected to major trauma, or undergone complicated surgery, especially of the gastrointestinal tract? About half of the patients have a prior or concurrent bacterial infection usually resulting in tissue damage. 5 About 90% of patients are receiving broad-spectrum antibacterial antibiotics and about half are receiving parenteral nutrition. Candida infection is unlikely to occur in patients who are not already colonized by the organism. 6 There are no characteristic signs or symptoms to suggest the diagnosis of disseminated candidiasis. Patients typically present with persistent or recurrent fever despite broad-spectrum antibacterial therapy. Pneumonia, deteriorating liver or renal function, and general deterioration may occur. Adrenal corticosteroid therapy may mask fever. Some patients present with symptoms suggestive of endotoxin shock. 7 Ocular involvement is present in from 5% to 45% of patients, s It is rare in neutropenic patients. Characteristic skin lesions have been described in about 10% of patients. 9 The lesions are discrete, nontender, firm, raised nodules