Cytologic Detection and Clinical Significance of Candida Species in Sputum: A Comprehensive Review
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Date
2025-06
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Educational Society for Excellence
Abstract
Candida species are common commensals of the oro?pharyngeal mucosa, yet their presence in sputum cytology continues to generate diagnostic uncertainty. This narrative review synthesises cytomorphologic hallmarks, diagnostic adjuncts, and evolving clinical evidence to guide cytopathologists and clinicians in differentiating colonisation from true infection. Characteristic sputum findings include 3–4?µm budding yeasts with elongated pseudohyphae penetrating desquamated squamous cells amid acute inflammation. Conventional culture remains standard but is slow and less sensitive; fluorescent real?time PCR, ??d?glucan, and mannan/ anti?mannan assays provide faster, more sensitive detection, although interpretation still hinges on clinicoradiologic correlation. Recent series show that while invasive Candida pneumonia is exceedingly rare (<1?%), persistent lower?respiratory colonisation is associated with higher mortality in hospital?acquired pneumonia, more frequent exacerbations in COPD, and impaired lung function in bronchiectasis. Judicious reporting e.g., “Candida spp. present; may represent colonisation versus infection in the appropriate clinical context”together with adherence to IDSA antifungal guidelines, optimises patient management.
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Keywords
Candida, Sputum cytology, Pseudohyphae, PCR, ??d?glucan, Colonisation, Pneumonia
Citation
Rathod G, Teja AA, Sai S. Cytologic Detection and Clinical Significance of Candida Species in Sputum: A Comprehensive Review. International Archives of Integrated Medicine. 2025 Jun; 12(6): 1-4