Candida glabrata is a relatively non-pathogenic fungus that is part of the normal flora of many healthy individuals. However, the recent widespread use of immunosuppressive and antifungal drugs has lead to an increase in the number of infections caused by C. glabrata. In fact, according to an article published in the January 1999 edition of Clinical Microbiology Reviews, C. glabrata is the second most common cause of candidiasis after C. albicans. Antifungal drugs are the mainstay of the treatment.
Antifungals such as amphoterecin B and azole drugs are commonly used to treat C. glabrata infections. The dosage, mode of administration and the duration of the treatment depend upon the the site of the infection and the severity of the condition. Patients with invasive infections such as those of blood, bones, heart, urinary tract and the brain are treated with intravenous amphoterecin B or flucanozole for 48 to 72 hours until the infection is under control. This is followed by oral administration of the drugs for 2 to 6 weeks for the complete eradication of C. glabrata from the patient's body. However, according to the John Hopkins Point of Care Information Technology Center, strains of C. glabrata exhibit significant resistance to flucanozole and other azole drugs. Patients being treated with these drugs should be continuously monitored for treatment response. Amphoterecin B, on the other hand, can cause severe side effects, especially when given intravenously. Caspofungin is another antifungal that can be used, although its efficacy to treat invasive infections has not been well studied.
Mucosal infections of C. glabrata such as thrush and esophagitis are generally mild and can be treated with oral antifungals such as clotrimazole, flucanozole, itraconazole, nystatin and amphoterecin B. The drugs are prescribed for 7 to 14 days to be taken two times a day. Antifungals are also available in ointment form and can be applied topically to treat vaginal and skin infections caused by C. glabrata.
The invasive C. glabrata infections are commonly associated with fever and anti-pyretics, such as acetaminophen, ibuprofen and aspirin, can be used to bring down the body temperature. These drugs are available in the pharmacy without prescription and can be used as and when required. MedlinePlus, however, warns against the use of aspirin in children younger than 18 years of age due to the risk of developing an serious side effect known as Reye syndrome that leads to swelling of the liver and the brain.
Patients with C. glabrata infections of bloodstream, lungs and brain may also experience shortness of breath. Oxygen therapy, which involves administration of oxygen at a concentration higher than that of the room atmosphere using a facial mask or a nasal cannula, can be used to provide relief from breathing difficulties.
Surgical drainage or the removal of infected tissue may be required to treat certain cases of invasive C. glabrata infections such as those of prosthetic valves. An article in the November 2006 edition of the Infectious Diseases in Clinical Practice states that treatment of native valve endocarditis caused by C. glabrata is unsuccessful even after one week of extensive antifungal therapy and surgical intervention is required. In fact, the study states that a combination of surgery and antifungals are required to treat prosthetic valve endocarditis caused by C. glabrata.
- "Clinical Microbiology Reviews"; Candida glabrata: Review of Epidemiology, Pathogenesis, and Clinical Disease with Comparison to C. albicans.; Paul L. Fidel Jr. et al; January 1999
- John Hopkins Point of Care Information Technology Center: Candida Species
- MedlinePlus: Reye Syndrome
- "Infectious Diseases in Clinical Practice"; Prosthetic Valve Endocarditis Due to Candida glabrata: A Case Report; Rafik Samuel et al; November 2006