MBBS OSCE · General Medicine
OSCE — Candidiasis & Invasive Fungal Infection
Eight-minute OSCE station on Candidiasis & Invasive Fungal Infection: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Candidiasis & Invasive Fungal Infection.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Candidiasis is infection by Candida yeasts (commonly C. albicans and increasingly non-albicans species), spanning mucocutaneous forms — oral thrush, vulvovaginal candidiasis, oesophageal (AIDS-defining), cutaneous (intertrigo, balanitis) — and invasive candidiasis (candidaemia and deep-seated infection) in the critically ill, immunocompromised, post-surgical, central-line, broad-spectrum-antibiotic, parenteral-nutrition patient. Risk factors: neutropenia, ICU/critically ill, central venous catheter, TPN, broad-spectrum antibiotics, diabetes, steroids, abdominal surgery, malignancy. Invasive candidiasis presents with fever unresponsive to antibiotics, sepsis, and may seed the eye (endopht
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Critically ill/ICU patient with persistent fever despite broad-spectrum antibiot |
| Safety | Neutropenic patient with fever and new skin nodules - disseminated candidiasis o |
| Safety | New visual change in a patient with candidaemia - Candida endophthalmitis; urgen |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.