Pediatric Candidiasis Workup

Updated: Dec 17, 2018
  • Author: Sabah Kalyoussef, DO; Chief Editor: Russell W Steele, MD  more...
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Workup

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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