Candidiasis or monilial infection is caused by group of yeasts which are normally inhabitants of the intestinal tract and can over grow and cause disease in skin and mucous membrane in several ways. The causative organism is usually candida Albicans but may also be C.tropicalis or C. Parapsilosis or C. Krusel. The disease occurs in extremes of life (Elderly and young), immuno compromised people such as diabetics, those with HIV infection, or on immuno suppressive therapy or broad spectrum antibiotics or those with cellular immune deficiency.
Candidiasis infection commonly involves the oral cavity. Monilial stomatitis occurs as thrush in infants when there is white easily detachable layer over the mucosa. Adults have angular stomatitis in the form of painful cracking at the angle of the month. Monilial vulvo vaginitis is an important cause of pruritis of vulva in females.
Candida infection predominantly occurs at sites which are chronically wet and macerated. Common sites are flexural areas such as under pendulous breasts, inner aspects of thighs, scrotal area, in- between fingers and around nails when there is swelling of nail folds especially in those who do lot of wet work. Diagnosis of Candida is made by KOH mount and culture. Treatment is to be directed towards the underlying cause, obesity diabetes, immune suppression and due care towards moisture in flexural area must be looked into.
Topical Imidazoles (Clotrimazole, Miconazole, Ketoconazole) are effective. Systemic antifungals like Fluconazole, Ketoconazole, Itraconazole may be used in deep-seated Candidiasis and in immuno compromised patients.
