Difference between revisions of "Candidiasis"

Latest revision as of 17:05, 30 December 2014

Introduction

Candida spp

Candidiasis is a fungal infection caused by Candida spp., most commonly Candida ablicans that affects many species.

The yeast is normally present on skin and in the GI tract. Symptoms of disease are usually only seen in immunocompromised animals following opportunistic infection. It is most common in the bird (see Candidiasis - Birds) but has also been reported in rabbits, horses, pigs, cows, sheep, cats and dogs - in particular neonates.

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.

Gross clinical signs include:

Exudative, papular, pustular to ulcerative dermatitis
Raised, circular white plaques or ulcers with overlying scabs
Keratinous thickening of tissue
Stomatitis and otitis externa

Microscopically there is evidence of:

Spongiotic neutrophilic pustular inflammation
Parakeratosis
Ulcerations
Superficial exudate containing organisms

Infection may 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.

Predisposing factors

Immunosuppressive drugs
Immunosuppressive disease
Indwelling urinary or intravenous catheters
Antibiotic administration

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

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

Prognosis

Prognosis depends on both the severity of infection and the animal affected.

Also see:

Candidiasis in Birds

Candidiasis in Rabbits

References

Merck & Co (2009) The Merck Veterinary Manual (Ninth Edition), Merial

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-=Introduction=
+{{OpenPagesTop}}
-*Caused by [[Candida spp.|''Candida'' spp.]]
+==Introduction==
-*Noramlly present on skin and in [[Alimentary System Overview - Anatomy & Physiology|GI tract]]
+[[File:C albicans germ tubes.jpg|200px|right|thumb|''Candida'' spp]]
-*Immunocompromised animals may show symptoms
+Candidiasis is a '''fungal infection''' caused by [[Candida spp.|''Candida'' spp.]],  most commonly '''''Candida ablicans''''' that affects many species.
-*Usually lesions on mucous membranes and at mucocutaneous junctions
-*Grossly:
-**Exudative, papular, pustular to ulcerative dermatitis
-**Stomatitis and otitis externa may develop
-*Microscopically:
-**Spongiotic neutrophilic pustular inflammation
-**Parakeratosis
-**Ulcerations
-**Superficial exudate containing organisms
-=Candidasis in birds=
+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 (see [[Candidiasis - Birds]]) but has also been reported in [[Candidiasis – Rabbit|rabbits]], horses, pigs, cows, sheep, cats and dogs - in particular neonates.
-==Signalment==
+==Clinical Signs==
-The disease is common in '''neonatal psittacine birds'''. '''Immunosuppressive''' conditions and '''trauma''' to the ingluvies lead to the development of candidiasis. Predisposing factors include hypothermia, feeding a formula that is too cold or too hot - causing crop burns, poor nutrition, longterm antibiotic therapy, hypovitaminosis A and systemic illness from other causes.
+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'''.
-==Clinical Sings==
+Gross clinical signs include:
-The bird may present with '''inflammation''' and '''delayed emptying''' of the '''ingluvies'''.
+* '''Exudative''', '''papular''', '''pustular''' to '''ulcerative dermatitis'''
+* '''Raised''', '''circular white plaques''' or '''ulcers''' with overlying '''scabs'''
+* '''Keratinous thickening''' of tissue
+* [[Stomatitis|'''Stomatitis''']] and [[Otitis Externa - Cat and Dog|'''otitis externa''']]
+Microscopically there is evidence of:
+*Spongiotic neutrophilic pustular [[Inflammation|'''inflammation''']]
+*'''Parakeratosis'''
+*'''Ulcerations'''
+*Superficial [[Exudate|'''exudate''']] containing organisms
+Infection may 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==
+* Immunosuppressive drugs
+* Immunosuppressive disease
+* Indwelling urinary or intravenous catheters
+* Antibiotic administration
 ==Diagnosis==
-Diagnosis is based on '''identification of oval yeasts''' and '''hyphae''' on '''cytological smears''' taken from swabs and crop washes or aspirates. '''Wrights stain''' can be used to demonstrate the yeasts. There should be no evidence of an inflammatory response. The presence of '''hyphae''' indicates that the crop may have been penetrated and the infection '''spread systemically'''.
+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==
-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''' – e.g. itraconazole PO for 7 days – should be used along with a local or topical antifungal, e.g. nystatin BID or TID for 7–10 days.
+'''Topical''' or '''systemic anti-fungals''' are used to treat the infection.
 ==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.
+Prognosis depends on both the severity of infection and the animal affected.
+<big><b>
+Also see:
+:[[Candidiasis - Birds|Candidiasis in Birds]]
+:[[Candidiasis – Rabbit|Candidiasis in Rabbits]]
+</b></big>
 ==References==
-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''
+Merck & Co (2009) '''The Merck Veterinary Manual''' (Ninth Edition), ''Merial''
+{{review}}
+{{OpenPages}}
 [[Category:Cutaneous Mycoses]]
-[[Category:To Do - Fungi]]
+[[Category:Expert Review]]
-[[Category:To Do - Manson]]
-[[Category: To Do - Siobhan Brade]]