RCP Medicine Podcast Episode 88: Mycology Unmasked: What Every Clinician Should Know
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Aug 1, 2025 
Neil Stone, a consultant in infectious diseases and microbiology at University College London, dives into the world of clinical mycology. He discusses the urgent issue of Candida auris, a multi-drug resistant fungus threatening healthcare. Challenges in diagnosing cryptococcal meningitis, especially in HIV patients, are explored, alongside the importance of proper diagnostics for effective treatment. Neil also highlights the rising significance of environmental health in relation to fungal diseases, pushing for a collaborative approach to patient care and management.
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Understanding Yeasts and Candida
- Yeasts are single-celled fungi, with Candida species being the most important in human medicine.
- Candida normally colonizes human mucosal sites but can cause serious invasive infections.
Managing Invasive Candidiasis
- Suspect invasive candidiasis in ICU patients with IV lines, broad-spectrum antibiotics, and abdominal surgery not responding to antibacterials.
- Always remove central lines and treat with echinocandins early for candidemia.
Urgency of Line Removal in Candidemia
- Always remove the infected line promptly to avoid complications like endocarditis and disseminated candidiasis.
- Get ophthalmology review in patients with candidemia who cannot report visual symptoms to check for eye involvement.