Candida Krusei

Candida krusei is one of the less common though emerging more frequently recently, cause of candidiasis in patients with hematological malignancies and the immunocompromised. It is estimated at being the cause of between 1-3% of cases. Other pathogenic species of candida include candida albicans, candida glabrata, candida dubliniensis, candida tropicalis, candida parapsilosis. There are many species of Candida but most are not pathogenic. Interestingly Candida krusei also has a role in chocolate production!

Treating Candida krusei
Candida krusei is can be resistant to fluconazole, one of the go to medications for systemic candidiasis. Patients with Candida krusei have a high mortality rate though it can be successfully treated with amphotericin B, voriconazole, anidulafungin, caspofungin and micafungin.

Candida krusei in the production of chocolate
When cacao beans have been harvested they then need to be fermented to get rid of the butter taste they have and to break them down. Two fungi are involved in this process, geotrichum and candida krusei. Often these fungi are already in the beans in the seeds or seed pods, but in these modern times, certain strains are used, and each chocolate company has their own selection for flavor and aroma.

The yeast reproduces quickly creating thousands of cells in a small area that then make enzymes which break down the pulp outside the cacao beans. This creates acetic acid which destroys the seed embryo, removes the bitterness and creates a chocolaty smell.

Candida krusei symptoms
Candida krusei is more likely to cause a systemic infection in hospitalized patients rather than in an otherwise healthy person. Symptoms in the latter include a white fuzzy film, burning irritation and itching. It can affect anywhere on the body including the mouth, skin, scalp, ears and genitals.

In weakened patients Candida krusei can lead to gastrointestinal candidiasis, it can invade the respiratory tract, and it can be systemic. Symptoms of systemic candida krusei include fever that is long lasting, skin lesions, infection of internal organs, septic shock. Clinical manifestations include fungaemia, endocarditis, arthritis and endophthalmitis. Candida krusei infections are more common amongst patients who have been administered fluconazole as a prophylactic, leading some to question whether this practice should be continued.

Candida krusei compared to other candida species
In clinical studies Candida krusei is less virulent than candida albicans in terms of forming biofilms on prosthetic and epithelial surfaces. It is also different in its structure, metabolic features and behavior patterns. Due to these differences there are some that say it should be reassigned.

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