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Pediatric Candidiasis Workup

  • Author: Sabah Kalyoussef, DO; Chief Editor: Russell W Steele, MD  more...
 
Updated: Feb 07, 2016
 

Laboratory Studies

The following studies are indicated in candidiasis:

Potassium hydroxide (KOH) slide preparation

Scrapings of oral or cutaneous lesions may demonstrate budding yeasts with pseudohyphae.

Cultures

Blood culture is highly insensitive but still recommended; fewer than 15% of patients with disseminated disease have positive blood cultures.

Urine culture is often positive in individuals who are immunocompromised and have renal or bladder disease.

Culture intravascular devices, especially indwelling catheters and especially in neonates suspected of having sepsis.

Beta-glucan assay

Component of fungal cell wall

D-arabinatol assay

Measures fungal metabolite

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Imaging Studies

Ultrasonography and CT scanning may be helpful in making the diagnosis of disseminated candidal infection in the individual who is immunocompromised, especially for renal, bladder, hepatic, and splenic lesions.

Endoscopy may be indicated for diagnosis of candidal esophagitis, especially when empiric treatment has failed.

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Procedures

Lumbar puncture is indicated for patients suspected of having candidal meningitis. Findings may include the following:

  • Elevated opening pressure
  • Increased WBC count, often with predominance of lymphocytes
  • Hyphae, which may be observed on Gram stain
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Contributor Information and Disclosures
Author

Sabah Kalyoussef, DO Attending Physician, Pediatric Infectious Diseases and Hospital Medicine, The Children's Hospital at St Peter's University Hospital

Sabah Kalyoussef, DO is a member of the following medical societies: American Academy of Pediatrics, Infectious Diseases Society of America, Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Mark R Schleiss, MD Minnesota American Legion and Auxiliary Heart Research Foundation Chair of Pediatrics, Professor of Pediatrics, Division Director, Division of Infectious Diseases and Immunology, Department of Pediatrics, University of Minnesota Medical School

Mark R Schleiss, MD is a member of the following medical societies: American Pediatric Society, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Society for Pediatric Research

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Itzhak Brook, MD, MSc Professor, Department of Pediatrics, Georgetown University School of Medicine

Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, Society for Ear, Nose and Throat Advances in Children, American Federation for Clinical Research, Surgical Infection Society, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

Acknowledgements

Michael E Greenberg, MD, MPH Clinical Instructor, Department of Pediatrics, University of California at San Francisco

Michael E Greenberg, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, and American Public Health Association

Disclosure: Nothing to disclose.

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Typical appearance of thrush. Note multiple white plaques on lips, gingivae, tongue, and palate.
Candidal diaper dermatitis. Note satellite papules and involvement of intertriginous folds.
 
 
 
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