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October 10, 1966, Vol 198, No. 2 >
ARTICLE | October 10, 1966

Candida albicans: Saprophyte or Pathogen?: Title and subTitle BreakA Diagnostic Guideline FREE

Philip J. Kozinn, MD; Claire L. Taschdjian, MS
[+] Author Affiliations

Reprint requests to 2220 Ocean Ave, Brooklyn, NY 11229 (Dr. Kozinn).


From the Department of Pediatrics, University of the State of New York Downstate Medical Center, and Maimonides Hospital (Dr. Kozinn) and the Department of Biology, Saint Francis College (C. L. Taschdjian), Brooklyn, NY.


JAMA. 1966;198(2):170-172. doi:10.1001/jama.1966.03110150118032
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References

Isolation of Candida albicans from a patient's stools, sputum, or urine tends to obfuscate rather than clarify the diagnosis. The clinician's uncertainty as to the significance of Candida or ganisms cultured from skin lesions or from blood, cerebrospinal fluid, and other internal foci has all too often delayed or prevented administration of specific therapy.

Much of the confusion concerning the diagnostic interpretation of C albicans isolated from clinical specimens stems from faulty concepts as to the saprophytic occurrence of the organism. Despite ample evidence to the contrary,1 many textbooks and articles still perpetuate the thoughtless statement that C albicans occurs saprophytically on normal skin. As a result, a Candida organism cultured from blood and other visceral specimens is often shrugged off as a "skin contaminant," with usually tragic consequences for the patient. Failure to recognize the role of C albicans in the etiology of skin lesions may lead to

REFERENCES

1 +
Winner, H.I., and Hurley, R.: Candida albicans , Boston: Little, Brown & Co., 1964;.
2 +
Hutter, R., and Collins, V.P.:  The Occurrence of Opportunistic Fungus Infections in a Cancer Hospital , Lab Invest 11:1035-1045, 1962;.
3 +
Louria, D.B.; Stiff, D.P.; and Bennett, B.:  Disseminated Moniliasis in the Adult , Medicine 41:307-337, 1962;.
4 +
Kozinn, P.J., and Taschdjian, C.L.:  Enteric Candidiasis: Diagnosis and Clinical Considerations , Pediatrics 30:71-85, 1962;.
5 +
Hildick-Smith, G.; Blank, H.; and Sarkany, I.: Fungus Diseases and Their Treatment , Boston: Little, Brown & Co., 1964;.
6 +
Frenzel, H., and Meinhof, W.:  Untersuchungen zur Hefebesiedlung des Bronchialbaumes , Prax Pneumol 19:346-355, 1965;.
7 +
Baum, G.L.:  The Significance of Candida albicans in Human Sputum , New Eng J Med 263:70-73, 1960;.
8 +
Gonzalez-Mendoza, A., and Bojalil, L.F.:  The Incidence of Candida albicans in the Sputum of Tuberculous Patients , Amer Rev Tuberc 77:543-545, 1958;.
9 +
Bergmann, M., and Lipsky, H.:  Ueber die Pilzbesiedlung des Urogenitaltraktes , Med Klin 59:732-734, 1964;.
10 +
Schirren, C.: " Hefepilze auf gesunder Haut ," in Schirren, C., and Rieth, H. (eds.): Hefepilze als Krankheitserreger bei Mensch und Tier , Berlin: Springer-Verlag, 1963;, pp 28-29.
11 +
Maibach, H.I., and Kliigman, A.M.:  The Biology of Experimental Human Cutaneous Moniliasis (Candida albicans) , Arch Derm 85:233-254, 1962;.
12 +
Ffrench, G., and Shenoi, V.S.:  Disseminated Moniliasis With Demonstration of the Organism in the Blood , Canad Med Assoc J 7:238-241, 1954;.
13 +
Caroline, L., et al:  Reversal of Serum Fungistasis by Addition of Iron , J Invest Derm 42:415-419, 1964;.
14 +
Summers, D.F., and Hasenclever, H.F.:  In Vitro Inhibition of Yeast Growth by Mouse Ascites Fluid and Serum , J Bact 87: 1-7, 1964;.
15 +
Louria, D.B., and Brayton, R.G.:  A Substance in Blood Lethal for Candida albicans , Nature 201:309, 1964;.
16 +
Kozinn, P.J.; Caroline, L.; and Taschdjian, C.L.:  Conjunctiva Contains Factor Inhibiting Growth of Candida albicans , Science 146:1479-1480, 1964;.
17 +
Taschdjian, C.L., and Kozinn, P.J.:  Laboratory and Clinical Studies of Candidiasis in the Newborn Infant , J Pediat 50:426-433, 1957;.
18 +
Haley, L.:  Yeast Infection of the Lower Urinary Tract , Sabouraudia 4:98-105, 1965;.
19 +
Gridley, M.F.:  Stain for Fungi in Tissue Sections , Amer J Clin Path 23:303-307 ( (March) ) 1953;.
20 +
Grocott, R.G.:  Stain for Fungi in Tissue Sections and Smears Using Gomori's Methenamine-Silver Nitrate Technic , Amer J Clin Path 25:975-979 ( (Aug) ) 1955;.
21 +
Seeliger, H.P.R.: " Die Laboratoriumsdiagnostik der Lungenmykosen ," in Deutscher Roentgenologenkongress 1963 , Stuttgart: Georg Thieme, 1964;, pt (A) , pp 121-130.
22 +
Schencker, B., and Zanca, P.:  Pulmonary Moniliasis: A Plea for Lung Biopsy , Milit Med 128:1027-1031, 1963;.

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1 +
Winner, H.I., and Hurley, R.: Candida albicans , Boston: Little, Brown & Co., 1964;.
2 +
Hutter, R., and Collins, V.P.:  The Occurrence of Opportunistic Fungus Infections in a Cancer Hospital , Lab Invest 11:1035-1045, 1962;.
3 +
Louria, D.B.; Stiff, D.P.; and Bennett, B.:  Disseminated Moniliasis in the Adult , Medicine 41:307-337, 1962;.
4 +
Kozinn, P.J., and Taschdjian, C.L.:  Enteric Candidiasis: Diagnosis and Clinical Considerations , Pediatrics 30:71-85, 1962;.
5 +
Hildick-Smith, G.; Blank, H.; and Sarkany, I.: Fungus Diseases and Their Treatment , Boston: Little, Brown & Co., 1964;.
6 +
Frenzel, H., and Meinhof, W.:  Untersuchungen zur Hefebesiedlung des Bronchialbaumes , Prax Pneumol 19:346-355, 1965;.
7 +
Baum, G.L.:  The Significance of Candida albicans in Human Sputum , New Eng J Med 263:70-73, 1960;.
8 +
Gonzalez-Mendoza, A., and Bojalil, L.F.:  The Incidence of Candida albicans in the Sputum of Tuberculous Patients , Amer Rev Tuberc 77:543-545, 1958;.
9 +
Bergmann, M., and Lipsky, H.:  Ueber die Pilzbesiedlung des Urogenitaltraktes , Med Klin 59:732-734, 1964;.
10 +
Schirren, C.: " Hefepilze auf gesunder Haut ," in Schirren, C., and Rieth, H. (eds.): Hefepilze als Krankheitserreger bei Mensch und Tier , Berlin: Springer-Verlag, 1963;, pp 28-29.
11 +
Maibach, H.I., and Kliigman, A.M.:  The Biology of Experimental Human Cutaneous Moniliasis (Candida albicans) , Arch Derm 85:233-254, 1962;.
12 +
Ffrench, G., and Shenoi, V.S.:  Disseminated Moniliasis With Demonstration of the Organism in the Blood , Canad Med Assoc J 7:238-241, 1954;.
13 +
Caroline, L., et al:  Reversal of Serum Fungistasis by Addition of Iron , J Invest Derm 42:415-419, 1964;.
14 +
Summers, D.F., and Hasenclever, H.F.:  In Vitro Inhibition of Yeast Growth by Mouse Ascites Fluid and Serum , J Bact 87: 1-7, 1964;.
15 +
Louria, D.B., and Brayton, R.G.:  A Substance in Blood Lethal for Candida albicans , Nature 201:309, 1964;.
16 +
Kozinn, P.J.; Caroline, L.; and Taschdjian, C.L.:  Conjunctiva Contains Factor Inhibiting Growth of Candida albicans , Science 146:1479-1480, 1964;.
17 +
Taschdjian, C.L., and Kozinn, P.J.:  Laboratory and Clinical Studies of Candidiasis in the Newborn Infant , J Pediat 50:426-433, 1957;.
18 +
Haley, L.:  Yeast Infection of the Lower Urinary Tract , Sabouraudia 4:98-105, 1965;.
19 +
Gridley, M.F.:  Stain for Fungi in Tissue Sections , Amer J Clin Path 23:303-307 ( (March) ) 1953;.
20 +
Grocott, R.G.:  Stain for Fungi in Tissue Sections and Smears Using Gomori's Methenamine-Silver Nitrate Technic , Amer J Clin Path 25:975-979 ( (Aug) ) 1955;.
21 +
Seeliger, H.P.R.: " Die Laboratoriumsdiagnostik der Lungenmykosen ," in Deutscher Roentgenologenkongress 1963 , Stuttgart: Georg Thieme, 1964;, pt (A) , pp 121-130.
22 +
Schencker, B., and Zanca, P.:  Pulmonary Moniliasis: A Plea for Lung Biopsy , Milit Med 128:1027-1031, 1963;.

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