Candida albicans, the fungus which is responsible for moniliasis, is a common inhabitant of the throat and not ordinarily a pathogen in the adult. In the presence of lowered host resistance by disease, corticosteroid therapy, immunosuppressive drugs or in the presence of altered normal flora by prolonged use of broad spectrum antibiotics, a candida infection may occur. Usually there is little difficulty in assessing the significance of this fungus when it is associated with visible mucus membrane or cutaneous lesions in healthy individuals. However, multiple or persistent isolations of the fungus from body fluids even after the removal of provocative factors such as antibiotics and foreign bodies indicates an invasive disease which requires specific therapy. Mucocutaneous and superficial Candida infections usually respond to topical therapy such as nystatin spray or gargle. When this is ineffective and the patient is still symptomatic, low doses of intravenously administered amphotercin B should be considered as the next step in the management of the infection. In patients with Candida meningitis or endocarditis this regimen is not recommended.
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