Pathogenesis and management of Candida infection syndromes in non-neutropenic patients.

Infections due to Candida spp. are increasingly common. Despite a number of studies examining the characteristics of fungemic (non-neutropenic) patients, there are no prospective studies defining indications for therapy before the appearance of fungemia. This article reviews the potential pathways for dissemination of Candida from the gastrointestinal tract, believed to be the primary entry route for yeast. Particular attention is focused on mucosal shedding at the villous tip and the potential role of microfold cells in this process. Therapeutic usage of amphotericin B, the agent of choice for serious Candida infection, is reviewed, along with usage of 5-flucytosine and fluconazole.