Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix.

Amrita School of Medicine Amrita Vishwa Vidyapeetham Kochi India

Basic and Translational Research Unit Special Unit for Biomedical Research and Education School of Medicine Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece; Hippokration General Hospital Thessaloniki Greece; Infectious Diseases Unit 3rd Department of Pediatrics School of Medicine Faculty of Health Sciences Aristotle University of Thessaloniki Thessaloniki Greece

BioTechMed Graz Austria; Division of Infectious Diseases Department of Internal Medicine Medical University of Graz Austria

BioTechMed Graz Austria; Division of Infectious Diseases Translational Medical Mycology Research Unit ECMM Excellence Center Medical University of Graz Graz Austria

Center for Biomedical Research in Network in Infectious Diseases Instituto de Salud Carlos 3 Madrid Spain; Mycology Reference Laboratory National Centre for Microbiology Instituto de Salud Carlos 3 Majadahonda Spain

Centers for Disease Control and Prevention Atlanta GA USA

Centre for Infectious Diseases and Microbiology Laboratory Services Institute of Clinical Pathology and Medical Research New South Wales Health Pathology Westmead Hospital Sydney NSW Australia; Department of Infectious Diseases Westmead Hospital Sydney NSW Australia; Faculty of Medicine and Health The University of Sydney Sydney NSW Australia

Centre of Excellence for Genetic Research in Infection and Immunity Research Institute of the McGill University Health Centre Montreal QC Canada; Division of Infectious Diseases Department of Medicine McGill University Health Centre Montreal QC Canada; Division of Medical Microbiology OPTILAB Department of Laboratory Medicine McGill University Health Centre Montreal QC Canada

Clemenceau Medical Center Dubai United Arab Emirates

Clinic for Infectious and Tropical Diseases Faculty of Medicine University Clinical Center of Serbia University of Belgrade Belgrade Serbia

Clinical and Diagnostic Microbiology Section Department of Pathology Medical College East Africa Aga Khan University Nairobi Kenya

Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Marañón Madrid Spain; Instituto de Investigación Sanitaria Gregorio Marañón Madrid Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias Madrid Spain; Faculty of Health Sciences HM Hospitals Universidad Camilo José Cela Madrid Spain

Clinical Microbiology Laboratory Attikon University General Hospital National and Kapodistrian University of Athens Athens Greece

Consultant Paediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute Mumbai India

Department for Laboratory Medicine Division of Clinical Microbiology ECMM Excellence Center Medical University of Vienna Vienna Austria

Department of Anaesthesia Intensive Care and Emergency University Hospital Policlinico Paolo Giaccone Palermo Italy; Department of Precision Medicine in Medical Surgical and Critical Care University of Palermo Palermo Italy

Department of Anaesthesiology and Critical Care Medicine CHU Bichat Claude Bernard AP HP Nord Assistance Publique Hôpitaux de Paris Paris France; Physiopathology and Epidemiology of Respiratory Diseases French Institute of Health and Medical Research U1152 University Paris Cité Paris France; UFR Médecine Paris Cité University Paris Cité Paris France

Department of Basic and Clinical Studies University of Nicosia Medical School Nicosia Cyprus

Department of Biology College of Science University of Babylon Hilla Iraq; Microbiology Laboratory Department of Laboratory Medicine and Pathology Hamad Medical Corporation Doha Qatar

Department of Clinical Microbiology and Immunology School of Medicine Tel Aviv University Tel Aviv Israel

Department of Clinical Microbiology ECMM Excellence Center Trinity College Dublin Dublin Ireland; Department of Microbiology Children's Health Ireland at Temple Street Dublin Ireland; Department of Microbiology Royal College of Surgeons in Ireland Dublin Ireland

Department of Clinical Mycology Allergology and Immunology Northwestern State Medical University named after 1 I Mechnikov St Petersburg Russia

Department of Geriatric Hematology Fondazione Policlinico Universitario A Gemelli IRCCS Università del Sacro Cuore Rome Italy

Department of Infectious Diseases Graduate School of Biomedical Sciences Nagasaki University Nagasaki Japan; Department of Respiratory Medicine Nagasaki University Hospital Nagasaki Japan

Department of Infectious Diseases Hospital Clinic of Barcelona IDIBAPS Barcelona Spain; Department of Medicine Universitat de Barcelona Barcelona Spain

Department of Infectious Diseases Jupiter Hospital Pune India

Department of Infectious Diseases National Medical Center for Infectious Diseases Huashan Hospital Fudan University Shanghai China

Department of Infectious Diseases Peter MacCallum Cancer Centre Melbourne VIC Australia; National Centre for Infections in Cancer Peter MacCallum Cancer Centre Melbourne VIC Australia; Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne VIC Australia

Department of Infectious Diseases School of Medicine Faculty of Medical and Health Sciences Tel Aviv Sourasky Medical Center Tel Aviv University Tel Aviv Israel

Department of Internal Medicine Division of Infectious Diseases American University of Beirut Medical Center Beirut Lebanon; Center for Infectious Diseases Research Faculty of Medicine and University Hospital American University of Beirut Medical Center Beirut Lebanon; Department of Internal Medicine Division of Infectious Diseases Faculty of Medicine and University Hospital Duke University Medical Center Durham NC USA

Department of Internal Medicine Division of Infectious Diseases Faculty of Medicine and University Hospital Duke University Medical Center Durham NC USA

Department of Internal Medicine Division of Infectious Diseases University of California Davis Medical Center Sacramento CA USA

Department of Internal Medicine Hematology and Oncology University Hospital Brno Masaryk University Brno Czech Republic

Department of Laboratory Medicine and National Reference Center for Mycosis ECMM Excellence Center University Hospitals Leuven Leuven Belgium; Laboratory of Clinical Microbiology Department of Microbiology Immunology and Transplantation KU Leuven Leuven Belgium

Department of Life Sciences National Chung Hsing University Taichung Taiwan; Department of Microbiology School of Clinical Medicine Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong Special Administrative Region China; The iEGG and Animal Biotechnology Research Center National Chung Hsing University Taichung Taiwan

Department of Medical Microbiology and Immunology Faculty of Medicine Gulu University Gulu Uganda

Department of Medical Mycology Westerdijk Fungal Biodiversity Institute Utrecht Netherlands; Department of Medical Microbiology University Medical Center Utrecht Utrecht Netherlands; Institute for Biodiversity and Ecosystem Dynamics University of Amsterdam Amsterdam Netherlands

Department of Medicine Division of Infectious Diseases Johns Hopkins University School of Medicine Baltimore MD USA

Department of Medicine Division of Infectious Diseases University of Texas Health Science Center at San Antonio San Antonio TX USA

Department of Medicine Divisions of Critical Care and Pulmonology Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa

Department of Medicine Federal University of São Paulo São Paulo Brazil; Antimicrobial Resistance Institute of São Paulo São Paulo Brazil

Department of Medicine Harvard Medical School Boston MA USA; Division of Infectious Diseases Massachusetts General Hospital Boston MA USA

Department of Medicine University of Toronto Toronto ON Canada

Department of Microbiology Amrita Institute of Medical Sciences Amrita Vishwa Vidyapeetham Kochi India

Department of Molecular Medicine University of Padua Padua Italy

Department of Oncohematology National Cancer Institute Faculty of Medicine Comenius University Bratislava Slovakia

Department of Parasitology and Medical Mycology Military Teaching Hospital Mohammed the fifth Faculty of Medicine and Pharmacy University Mohamed the fifth Rabat Morocco

Department of Pathology and Laboratory Medicine Aga Khan University Karachi Pakistan

Department of Pathology and Laboratory Medicine University of Texas Health Science Center at San Antonio San Antonio TX USA

Department of Pediatrics Division of Hematology Oncology and Hemostaseology Goethe University Frankfurt Frankfurt Germany

Department of Pediatrics Infectious Diseases Unit Hospital Dr Luis Calvo Mackenna Universidad de Chile Santiago Chile

Department of Pharmacy Pharmacology and Health Technologies Faculty of Pharmacy University of Lisbon Lisbon Portugal; Instituto de Saúde Ambiental Faculdade de Medicina Universidade de Lisboa Lisbon Portugal; Laboratório Associado TERRA Laboratório para o Uso Sustentável da Terra e dos Serviços dos Ecossistemas Instituto Superior de Agronomia Lisbon Portugal

Department of Radiology University of Florida Gainesville FL USA

Division of Clinical Microbiology Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden

Division of Infectious Diseases Ajmera Transplant Center Antimicrobial Stewardship Program University Health Network University of Toronto Toronto ON Canada

Division of Infectious Diseases and Tropical Medicine Department of Medicine Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand

Division of Infectious Diseases Department of Internal Medicine Hospital Regional Monterrey Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Monterrey Mexico

Division of Infectious Diseases Department of Medicine Duke University Durham NC USA; Durham County Department of Public Health Durham NC USA

Division of Infectious Diseases Department of Medicine National University Health System Singapore

Division of Infectious Diseases McGovern Medical School University of Texas Health Science Center at Houston Houston TX USA

Division of Infectious Diseases University of Alabama at Birmingham Birmingham AL USA

Division of Infectious Diseases Washington University School of Medicine ECMM Excellence Center St Louis MO USA

Division of Medical Microbiology Faculty of Health Sciences National Health Laboratory Service University of Cape Town Cape Town South Africa; Groote Schuur Hospital Institute of Infectious Disease and Molecular Medicine Faculty of Health Sciences University of Cape Town Cape Town South Africa

Division of Mycology Department of Microbiology Faculty of Medicine University of Çukurova Adana Türkiye

Faculty of Medicine Universitas Kristen Indonesia Jakarta Indonesia

Fungal Pathogenesis Section Laboratory of Clinical Immunology and Microbiology National Institute of Allergy and Infectious Diseases National Institutes of Health Bethesda MD USA

Hospital Policlinico San Martino IRCCS and Department of Health Science University of Genoa Genoa Italy

Hospital Policlinico San Martino IRCCS and Department of Health Science University of Genoa Genoa Italy; Division of Infectious Diseases Department of Health Sciences University of Genova Genova Italy

Infectious Disease Research Program Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology University Children's Hospital Münster University of Münster Münster Germany

Infectious Diseases Division University of Pittsburgh Pittsburgh PA USA

Institute for Hygiene and Medical Microbiology ECMM Excellence Center Medical University of Innsbruck Innsbruck Austria

Institute for Medical Microbiology ECMM Excellence Center University Medicine Essen University Duisburg Essen Essen Germany

Institute for Medical Microbiology Immunology and Hygiene University Hospital Cologne and Faculty of Medicine University of Cologne Cologne Germany

Institute of Clinical Microbiology Infectious Diseases and Infection Control Klinikum Nuremberg Paracelsus Medical University Nuremberg Germany; Institute of Medical Microbiology University Hospital Essen Essen Germany

Institute of Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases Excellence Center University of Cologne Cologne Germany

Institute of Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany; Center of Expertise for Mycology Radboud University Medical Center and Canisius Wilhelmina Hospital Nijmegen Netherlands

Institute of Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases Faculty of Medicine University Hospital Cologne University of Cologne Cologne Germany

Institute of Translational Research Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases partner site Bonn Cologne Cologne Germany

Manchester Fungal Infection Group School of Biological Sciences Faculty of Biology Medicine and Health The University of Manchester Manchester UK

Medical Mycology Unit Department of Microbiology Vallabhbhai Patel Chest Institute University of Delhi Delhi India; National Reference Laboratory for Antimicrobial Resistance in Fungal Pathogens Vallabhbhai Patel Chest Institute University of Delhi Delhi India

Medical Research Council Centre for Medical Mycology ECMM Excellence Center University of Exeter Exeter UK

Microbiology Laboratory Johns Hopkins Hospital Baltimore MD USA; Department of Pathology Johns Hopkins University School of Medicine Baltimore MD USA

Microbiology Research Laboratory Natural and Medical Sciences Research Center University of Nizwa Nizwa Oman

Mycology Reference Centre Manchester ECMM Excellence Center Department of Infectious Diseases Manchester Academic Health Science Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Manchester UK; Division of Evolution Infection and Genomics Faculty of Biology Medicine and Health The University of Manchester Manchester UK

Mycology Unit Department of Medical Microbiology Faculty of Medicine Hacettepe University Ankara Türkiye

National Reference Center for Invasive Fungal Infections Leibniz Institute for Natural Product Research and Infection Biology Hans Knoell Institute Jena Germany; Institute for Hygiene and Microbiology University of Wuerzburg Wuerzburg Germany

Parasitology and Mycology Unit Diagnosis and Treatment Department JM Ramos Mejia Hospital Department of Immunology Parasitology and Microbiology School of Medicine University of Buenos Aires Buenos Aires Argentina

Pathology Section for Pathobiological Sciences Faculty of Health and Medical Science University of Copenhagen Copenhagen Denmark

Pediatric Oncology Institute GRAACC Federal University of São Paulo São Paulo Brazil; Infectious Diseases Pediatric Department Federal University of São Paulo São Paulo Brazil

Public Health Wales Microbiology Cardiff University Hospital of Wales Cardiff UK; Cardiff University Centre for Trials Research University Hospital of Wales Cardiff UK

South Pest Central Hospital National Institute of Hematology and Infectology Budapest Hungary

Unit for Mycology Statens Serum Institut Copenhagen Denmark; Department of Clinical Microbiology Rigshospitalet University of Copenhagen Copenhagen Denmark; Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

University of Pittsburgh School of Medicine University of Pittsburgh Pittsburgh PA USA

Erratum v

Lancet Infect Dis. 2025 Apr;25(4):e203. doi: 10.1016/S1473-3099(25)00154-9. PubMed

Erratum v

Lancet Infect Dis. 2025 May;25(5):e261. doi: 10.1016/S1473-3099(25)00252-X. PubMed

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