1、DavidGrant AetiologyAetiologyCandidaspp.,especiallyC.normalinhabitant(commensalendo-saprophyte)ofthe alimentary, upper respiratory and ano-genital mucosaround to oval yeast organism which is able to produce a myceliumandchlamydosporesinculture圓形至橢圓酵母producesacidproteinases,keratinasesand phospholipa

2、ses (virulence factors)PathogenesisofprolongeduseofPathogenesisofprolongeduseofdrugscorticosteroids,immunosuppressivesantibiotics(esp.broad-抗生素（特別是廣譜抗生素ingdiseases,disruptionofcutaneous/mucosal皮膚/Burns persistentmoisture,macerationindwellingcathetersClinicalfeatures臨床特rareinfectioninClinicalfeatures

3、臨床特rareinfectioninsmallanimals morefrequently reported in罕mucousmembranesandhumid/softened粘膜和潮濕/cutaneous softensecondaryto(oral, vaginal) 皮膚病變經常繼發于粘膜（）Clinicalpicture臨床表whiteopaquefilmorcoat,milky/cheesyClinicalpicture臨床表whiteopaquefilmorcoat,milky/cheesy白色不透明的薄，奶油色/skin and mucosa are erythematous

4、 and ulcerated ie皮膚和粘膜發紅和潰瘍深度侵入組hemouth:whiteplaquesandulcerationofthemucous lining of the cheeks and ventral tongue and foul-smelling otitisexterna,paronychia,pruritusmay炎CourtesyCourtesyDidierDifferentialdiagnosispyoderma,acutemoistothercausesDifferentialdiagnosispyoderma,acutemoistothercausesofot

5、itisertrigo(foldpyoderma擦疹ulcerativeautoimmunediseases junctional diseases, LE)性皮炎drugeruptions,NMEhepatocutaneoussyndrome壞死移行紅斑-MF theliotropiclymphoma蕈樣肉芽腫-leishmaniasis,Cytologyofdirectsmear直接涂片的細胞Cytologyofdirectsmear直接涂片的細胞學檢stainwithlactophenolcottonbluedegeneratedneutrophilsnumerousroundtoova

6、lyeasts(2-大量圓形至橢圓形的酵母菌(2-子芽細胞(budding （ narrow-basemultilateral alCourtesyCourtesyDidierBiopsy(H&E or活檢(H&Eordermitis,allyBiopsy(H&E or活檢(H&Eordermitis,allysuppurativeyeastsandhestratum ,al(pseudo) 酵母菌和芽生孢子存在于角質層，偶見（假）Diagnosis診Diagnosis診Fungalculture(25-30C,24-真菌培養(25-30C,24-Sabourauddextroseagaris

7、olationofafewcoloniesfromsalivaorfaeceshasno pathological significancetruecandidainfectiononlyifyeastispresentinlarge numbers and if mycelium is detected in vivoAPIsystemtoidentifycandidaspecies API 系統鑒定念珠菌種類J. van Cutsem, F. Rochette:MycosesJ. van Cutsem, F. Rochette:Mycosesin Domestic Animals, Janssen Research Foundation 1991TreatmentCorrectionTreatmentCorrectionofpredisposingTopicalagentsmi