Candida vs Cryptococcus
How to tell Candida and Cryptococcus apart when a board question makes them look alike.
Candida is pseudohyphae mucosal or catheter yeast; Cryptococcus is encapsulated yeast causing meningitis with antigen or India ink clues.
Side by side
Candida causes mucocutaneous thrush, vulvovaginitis, esophagitis, candidemia, endocarditis, or catheter-related infection with budding yeast and pseudohyphae.
Cryptococcus causes meningitis or pulmonary disease in immunocompromised patients, especially advanced HIV, with a thick polysaccharide capsule.
Candida is normal flora that overgrows with antibiotics, diabetes, immunosuppression, mucosal disruption, or intravascular catheters.
Cryptococcus is inhaled from environmental sources and its capsule helps evade phagocytosis before CNS dissemination.
Pseudohyphae, germ tube positivity for C. albicans, beta-D-glucan, thrush, or catheter bloodstream infection support Candida.
India ink halo, cryptococcal antigen, mucicarmine-positive capsule, narrow-based budding yeast, and high opening pressure support Cryptococcus.
The trap
Both are yeasts in immunocompromised hosts, so pseudohyphae versus capsule and mucosal/catheter versus CNS disease separate them.
The repair move
For yeast infections, match morphology to syndrome: pseudohyphae at mucosa/catheters or capsule in CSF.
Try a free question
CoreA 38-year-old man with poorly controlled HIV and CD4 count of 42 cells/uL presents with white plaques on his tongue and buccal mucosa that scrape off, leaving an erythematous base. Pain on swallowing has worsened over 1 week. Which organism is most likely responsible?
Show answer and explanation
Answer: A. Candida albicans. Mucocutaneous thrush with scrapeable white plaques and odynophagia in advanced HIV is the classic Candida albicans esophagitis pattern.
Why the other choices are tempting
- B. Cryptococcus neoformans causes subacute meningitis with high opening pressure and an encapsulated yeast on India ink, not scrapeable oral plaques.
- C. Histoplasma capsulatum causes mediastinal lymphadenopathy and intracellular yeast in macrophages after exposure to bird or bat droppings in endemic Mississippi or Ohio river valleys.
- D. Aspergillus fumigatus causes cavitary or angioinvasive pulmonary disease in neutropenic hosts, not mucocutaneous thrush.
- E. Pneumocystis jirovecii causes hypoxemic interstitial pneumonia with diffuse ground-glass infiltrates rather than oral plaques.
Flashcards
Tap a card to flip it.
What morphology supports Candida?
Budding yeast with pseudohyphae supports Candida infection.
What rapid test supports Candida albicans?
A positive germ tube test supports Candida albicans.
Quick answers
What is the fastest way to tell Candida from Cryptococcus?
Candida is pseudohyphae mucosal or catheter yeast; Cryptococcus is encapsulated yeast causing meningitis with antigen or India ink clues.
What is the key clue for Candida?
Candida causes mucocutaneous thrush, vulvovaginitis, esophagitis, candidemia, endocarditis, or catheter-related infection with budding yeast and pseudohyphae.
What is the key clue for Cryptococcus?
Cryptococcus causes meningitis or pulmonary disease in immunocompromised patients, especially advanced HIV, with a thick polysaccharide capsule.
What is the common trap with Candida vs Cryptococcus?
Both are yeasts in immunocompromised hosts, so pseudohyphae versus capsule and mucosal/catheter versus CNS disease separate them.