Candida albicans --- (yeast)
Endogenous Klebsiella endophthalmitis in a Vietnamese immigrant 2009
the common causative agents of endogenous endophthalmitis in North America are Candida species.
Endogenous endophthalmitis is a vision-threatening infection of the vitreous cavity that presents with pain, decreased
visual acuity and intraocular inflammation of the anterior and posterior segments. About 50%–80% of patients have
fever or other systemic symptoms such as arthralgia, fatigue, anorexia, nausea and vomiting. 1,2 Liver abscesses,
pneumonia, endocarditis and skin and soft tissue infections are the most common infectious foci associated with
endogenous endophthalmitis, although any source of bacteremia or fungemia can cause endophthalmitis.
C. albicans pathogenicity can be attributed to its ability to survive and thrive in multiple microenvironments within the
host, including multiple organs, the mucosa, and the bloodstream, and to virulence factors that aid in the adherence and
invasion of multiple cell types. One of the major virulence factors for C. albicans is its ability to form biofilms on
indwelling medical devices such as catheters. Systemic candidiasis can arise from C. albicans cells being released from
these biofilms, followed by colonization of mucosal surfaces, penetration of epithelial and endothelial cell barriers, and
dissemination throughout the body. Both budded and hyphal forms of C. albicans have been identified in infections and
are important for virulence, and the BHT is critical for systemic infections, a premise that was reinforced in non-virulent
C. albicans mutants defective in hyphal formation.
This species is the most commonly-isolated yeast in human disease. It has been implicated in both
superficial and systemic disease. Recent reports of infections include corneal , nail , ear ,
endocarditis , and bloodstream . Risk factors for infections with C. albicans include age of 65
years or above, immunosuppression prior to steroid use, leukocytosis, intensive care unit stays, or
presence of intravascular or urinary catheters. For those patients who have undergone cancer
chemotherapy and who often appear less critically ill, infections are most likely to be caused by Candida
species other than C. albicans . Although this species continues to be the most common species
isolated in bloodstream infections, reports show that the incidence is decreasing and the resistance is rare
in neonatal populations . Candida albicans is also a predominate species in fungal biofilms on medical
devises , .
There is a broad range of symptoms that have been associated with this syndrome. They can be classified in the
following groups, although it is not clear how many or which of them are required to make a diagnosis nor is there
scientific data linking these multiple clinical manifestations with Candida albicans overgrowth [220, 262]:
- Vaginal. Recurrent episodes of Candida vaginitis associated with the classic symptoms of pruritus, burning and
- Gastrointestinal. Heartburn, bloating, diarrhea or constipation.
- Respiratory allergy. Rhinitis, sneezing and/or wheezing.
- Central nervous system. Anxiety, depression, memory deficits and/or loss of ability to concentrate.
- Menstrual abnormalities. Severe premenstrual tension and/or menstrual irregularities.
- Other Systemic Symptoms. Fatigue, headache and/or irritability.