A Clinicomycological Study of Mucocutaneous Candidiasis

Subhashini, M (2012) A Clinicomycological Study of Mucocutaneous Candidiasis. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Candidiasis refers to a diverse group of infections caused by the yeasts of genus Candida which have been known for centuries. These organisms usually cause superficial infections involving the skin, nail, mucous membrane but can also produce serious systemic infections like septicemia, endocarditis and meningitis in immunosuppressed individuals. Candida species constitute a part of the normal flora of the digestive system and the female genital tract. Colonization with these organisms may occur during birth or later in life . In healthy individuals, such colonization is asymptomatic and their overgrowth is limited by the immune system and other bacteria occupying the gastrointestinal tract and vagina .When the immune system is deranged or an alteration in the ecology occurs, there is overgrowth of these organisms producing infection. There are over 200 species of Candida till date and their epidemiology is constantly changing with varying clinical patterns, virulence and antifungal susceptibility. AIM AND OBJECTIVES : Candida is an ubiquitious organism causing superficial fungal infection that is commonly encountered in clinical practice.Yeast infections caused by Candida is increasingly being reported worldwide. This increased incidence of infections are attributed to immunocompromised diseases like HIV and the development of wide range of newer immunosuppresives. A change in the epidemiology, clinical spectrum and antifungal susceptibility has been observed. The prompt detection of different species of yeast infections may aid for the appropriate treatment decisions. This study has been designed, 1. To study the age wise distribution of mucocutaneous candidiasis. 2. To study the sex wise distribution of mucocutaneous candidiasis. 3. To study the predisposing factors in individuals with mucocutaneous candidiasis. 4. To study the most common clinical features of mucocutaneous candidiasis 5. To identify the different species of candida by culture, subculture and appropriate biochemical tests in all patients with mucocutaneous candidiasis. 6. To identify the common blood group susceptible to mucocutaneous candidiasis MATERIALS AND METHODS : This study was conducted in Rajiv Gandhi Government General Hospital, Madras Medical college. One hundred new patients with symptoms and signs of mucocutaneous candidiasis attending the OPD, Mycology section of The Department of Dermatology were included in the study. Culture in SDA agar, Hichrome candida agar and biochemical tests like sugar fermentation were done for all patients with positivity for Candida in 10% KOH examination. INCLUSION CRITERIA : 1. Patients with symptoms and signs of mucocutaneous candidiasis. 2. Patients who test positive for Candida in KOH examination. 3. All patients including immunosuppressed, pregnant and pediatric age group are included. EXCLUSION CRITERIA : 1. Patients with negative results in KOH examination. 2. Those who are on topical for two weeks and systemic antifungals for four weeks prior to the study. Informed consent was obtained from all patients for their participation in this study. The skin and mucosal samples were collected and evaluated by appropriate laboratory methods. RESULTS : A total of 100 patients with features of mucocutaneous candidiasis who tested positive for Candida in KOH mount were selected for this study. The minimum age group affected was a one month old infant and maximum age group affected was 70 years (mean= 41.5 ). The maximum number of cases were found to be in the age group of 31-50. CONCLUSION : Mucocandidiasis can occur in all age groups with majority of the affected individuals in the age group of 31-50 years. • Females outnumbered the males and the male to female ratio was 1:2.7 • Mucocandidiasis was more common in immunosuppressed individuals than immunocompetent individuals. • ucosal candidiasis was more common than cutaneous candidiasis. • Oral candidiasis was the most common clinical presentation followed by vulvovaginal candidiasis. • Among the patients with oral candidiasis, pseudo membranous type was the most common presentation. The common predisposing factor was found to be immunosuppression. Candida albicans and Candida tropicalis were isolated in almost equal proportion in oral candidiasis. • Vulvovaginal candidiasis was more common among the immunosuppressed individuals. Candida tropicalis was isolated in higher number than Candida albicans. • Nonalbicans species were isolated in higher number than albicans species. • The nonalbicans species isolated were C.tropicalis, C.glabrata, C.krusei and C.parapsilosis. • Patients with O blood group had higher occurrence of mucocutaneous candidiasis. • In this study, C.tropicalis was isolated in higher number than C.albicans. Further studies in a larger population would provide more conclusive information on the changing trends in the epidemiology of candidal infections and would aid in the optimal treatment of patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Mucocutaneous Candidiasis ; Clinicomycological Study.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 01 Mar 2018 17:27
Last Modified: 03 Mar 2018 08:02
URI: http://repository-tnmgrmu.ac.in/id/eprint/5955

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