Candidiasis is an infection with yeast-forming fungi. Of the 150 Candida species known to date, only approximately 20 cause disease. By far the most frequent species is C. albicans. Other species such as C. tropicalis, C. glabrata and C. krusei are rare, but may respond less readily to treatment with azoles. Although it is commonly assumed that azole resistance is a problem particularly with albicans strains, this has not been the case to date (Sanglard 2002).
Candidiasis is an important indicator of immunodeficiency and should be seen as a reason to consider starting HAART, even with a good immune status. Esophageal candidiasis and even oral thrush often occur following other OIs. Fever, which is not a classic symptom of candidiasis, is a particular indication to be on the alert. If immune status is good, it must be remembered that there are also other reasons for thrush - alcoholism and steroid treatment are just two. In addition to candidiasis of the oropharynx and esophagus, vaginitis is a frequent problem in women (also occurring in healthy individuals). Candidemia occurs only rarely in HIV-infected patients, even with severe immunodeficiency.
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