Problemi speciali
La candidiasi mucocutanea cronica
Chronic mucocutaneous candidiasis
Lucrezia Guadrini, Raffaele Badolato
Clinica Pediatrica dell’Universitŕ di Brescia, Spedali Civili, Brescia
Giugno 2013 - pagg. 372 -376
Abstract
The mucocutaneous candidiasis (CMC) is a chronic condition characterized by persistent
or recurrent Candida infections ranging from superficial infections such as oral thrush, candidal
onychomycosis and genital mucosa infections to systemic potentially life-threatening
infections. Although oral thrush is a common finding in normal infants, relapsing Candida
infections can constitute an alerting sign of primary immunodeficiencies. In severe combined
immunodeficiencies, chronic granulomatous disease, common variable immunodeficiency,
or hyper IgE syndromes (e.g., Job syndrome, DOCK8 syndrome) fungal infections
are usually associated with viral or bacterial infections. In other cases, CMC is associated
to autoimmune polyendocrinopathy and ectodermal dystrophy (an autosomal
recessive condition known as APECED). Finally, CMC patients may present selected susceptibility
to Candida without evidence of other accompanying manifestations. Heterozygous
mutations of STAT1 constitute the leading cause of isolated CMC, but CARD9 and
CLEC7A mutations have also been observed in patients with autosomal recessive CMC.
Treatment of CMC patients is based on daily prophylaxis with fluconazole or itraconazole,
but resistance to antifungal drugs has also been observed.
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Corrispondenza: badolato@med.unibs.it