Changes

=Introduction=

=Introduction=

Candidiasis is a fungal infection caused by [[Candida spp.|''Candida'' spp.]], [[File:C albicans germ tubes.jpg|200px|right|thumb|''Candida'' spp]] most commonly ''Candida ablicans'' that affects many species.

Candidiasis is a '''fungal infection''' caused by [[Candida spp.|''Candida'' spp.]], [[File:C albicans germ tubes.jpg|200px|right|thumb|''Candida'' spp]] most commonly '''''Candida ablicans''''' that affects many species.

The yeast is normally present on skin and in [[Alimentary System Overview - Anatomy & Physiology|GI tract]] and symptoms of disease are usually only seen in immunocompromised animals following opportunistic infection.  It is most common in the bird but has also been reported in horses, pigs, cows, sheep, cats and dogs - in particular neonates.  

The yeast is normally present on '''skin''' and in the [[Alimentary System Overview - Anatomy & Physiology|GI tract]]. Symptoms of disease are usually only seen in '''immunocompromised''' animals following '''opportunistic''' infection.  It is most common in the bird but has also been reported in [[Candidiasis – Rabbit|rabbits]], horses, pigs, cows, sheep, cats and dogs - in particular neonates.  

==Clinical signs==  

==Clinical signs==  

Lesions are found on mucous membranes and at mucocutaneous junctions most commonly. The disease will usually remain localised to the mucocutaneous junctions, but on rare occasions it may spread systemically.

Lesions are found on '''mucous membranes''' and at '''mucocutaneous junctions''' most commonly. The disease will usually remain '''localised''' to the mucocutaneous junctions, but on rare occasions it may spread '''systemically'''.

Gross clinical signs include:

Gross clinical signs include:

* Exudative, papular, pustular to ulcerative dermatitis

* '''Exudative''', '''papular''', '''pustular''' to '''ulcerative dermatitis'''

* Raised, circular, white plaques or ulcers with overlying scabs

* '''Raised''', '''circular white plaques''' or '''ulcers''' with overlying '''scabs'''

* Keratinous thickening of tissue

* '''Keratinous thickening''' of tissue

* Stomatitis and otitis externa

* [[Stomatitis|'''Stomatitis''']] and [[Otitis Externa - Cat and Dog|'''otitis externa''']]

Microscopically there is evidence of:

Microscopically there is evidence of:

*Spongiotic neutrophilic pustular inflammation

*Spongiotic neutrophilic pustular [[Inflammation|'''inflammation''']]

*Parakeratosis

*'''Parakeratosis'''

*Ulcerations

*'''Ulcerations'''

*Superficial exudate containing organisms

*Superficial [[Exudate|'''exudate''']] containing organisms

Infection may cause a also cause a variety of other clinical signs depending on the species and the site of infection, for example mastitis, arthritis, diarrhoea and general malaise.

Infection may cause a also cause a variety of '''other clinical signs''' depending on the '''species''' and the '''site of infection''', for example [[Mastitis|mastitis]], [[Arthritis|arthritis]], [[Diarrhoea|diarrhoea]] and general malaise.

==Predisposing factors==

==Predisposing factors==

* Indwelling urinary or intravenous catheters

* Indwelling urinary or intravenous catheters

* Antibiotic administration

* Antibiotic administration

==Diagnosis==

==Diagnosis==

Diagnosis can be confirmed via microscopic examination and identification of the fungus following a skin scrap of the lesion. The fungus should be visible after staining with a Gram, Methylene Blue or Wrights stain. It is a gram positive ovoid, budding yeast with or without hyphae. Culture of a sample in Sabourauds Dextrose agar or Blood agar should also confirm diagnosis.

Diagnosis can be confirmed via '''microscopic examination''' and '''identification of the fungus''' following a '''skin scrape''' of the lesion. The fungus should be visible after staining with a Gram, Methylene Blue or Wrights stain. It is a '''gram-positive ovoid''', '''budding yeast''' with or without '''hyphae'''. '''Culture''' of a sample in Sabourauds Dextrose agar or Blood agar should also confirm diagnosis.

==Treatment==

==Treatment==

Topical anti-fungals are used to treat the infection.  

'''Topical''' or '''systemic anti-fungals''' are used to treat the infection.  

==Signalment==

==Signalment==

Candidiasis ''aka'' thrush/sour crop/crop mycosis is common in '''neonatal psittacine birds'''. It occurs primarily as a result of '''immunosuppression''' and '''trauma''' to the ingluvies. Hypothermia, feeding too cold or too hot formula which results in crop-burn, poor nutrition, longterm antibiotic therapy, hypovitaminosis A and systemic illness from other causes are all predisposing causes.  

Candidiasis ''aka'' '''thrush/sour crop/crop mycosis''' is common in '''neonatal psittacine birds'''. It occurs primarily as a result of '''immunosuppression''' and '''trauma''' to the ingluvies. Hypothermia, feeding too cold or too hot formula which results in crop-burn, poor nutrition, longterm antibiotic therapy, hypovitaminosis A and systemic illness from other causes are all predisposing causes.  

==Clinical Sings==

==Clinical Sings==

The bird may present with '''inflammation''' and '''delayed emptying''' of the '''ingluvies'''.

The bird may present with '''inflammation''' and '''delayed emptying''' of the '''ingluvies'''. On examination of the crop surrounding structures, there are normally grey-white lesions and a whitish necrotic material present. There may also be thickening of the crop wall.  

==Diagnosis==

==Diagnosis==

==Treatment==

==Treatment==

An '''antifungal drug''' is indicated for the treatment of candidiasis. The presence of hyphae is suggestive of invasion of the mucosa by the yeast and the potential for a systemic infection. Therefore, a '''systemic antifungal''' such as oral itraconazole (for 7 days) is recommended  along with a topical antifungal such as nystatin BID or TID for 7–10 days.

An '''antifungal drug''' is indicated for the treatment of candidiasis. The presence of hyphae is suggestive of invasion of the mucosa by the yeast and the potential for a systemic infection. Therefore, a '''systemic antifungal''' such as oral itraconazole (for 7 days) is recommended  along with a topical antifungal such as nystatin BID or TID for 7–10 days.

 

==Prognosis==

==Prognosis==

The presence of hyphae on cytological examination suggests a severe infection and potential systemic spread, and therefore a '''poor''' prognosis. Without evidence of hyphae the prognosis is improved.

The presence of hyphae on cytological examination suggests a severe infection and potential systemic spread, and therefore a '''poor''' prognosis. Without evidence of hyphae the prognosis is improved.

==References==

=References=

Forbes NA & Altman RB (1998) '''Self-Assessment Colour Review Avian Medicine''' ''Manson Publishing Ltd''

Forbes NA & Altman RB (1998) '''Self-Assessment Colour Review Avian Medicine''' ''Manson Publishing Ltd''

Girling, S (2004) '''Diseases of the digestive tract of psittacine birds''' ''In Practice 2004 26: 146-15''

Girling, S (2004) '''Diseases of the digestive tract of psittacine birds''' ''In Practice 2004 26: 146-15''

[[Category:Cutaneous Mycoses]]

[[Category:Cutaneous Mycoses]]

[[Category:To Do - Fungi]]

[[Category:To Do - Fungi]]

[[Category: To Do - Siobhan Brade]]

[[Category: To Do - Siobhan Brade]]