Post mortem studies of systemic candidiasis

Precipitating antibodies against a cytoplasmic extract of Candida albicans (“S” antigen) were demonstrated during life in 14 of 17 patients who revealed systemic candidal infection Post mortem. No false positive precipitin reactions were observed. Three false negative reactions are attributed to terminal or disease-related anergy. The precipitin reaction proved diagnostically more reliable than mycologic evidence of infection. However, no diagnostic test at present available reflects adequately the extent and severity of the infection in a given case. Both were considerable in the present series, in whom on the average three internal organs were involved per patient. The macrophages of the reticuloendothelial system are implicated in the destruction of Candida and release of the cytoplasmic antigens that induce the precipitin response. The yeast phase of Candida appears to be the invasive form, and neither tubes nor mycelia seem to be essential in evoking the inflammatory or necrotic tissue changes that characterize systemic candidiasis.