From Oral Candidiasis to Candidemia: A Review of Superficial to Invasive Progression.

Oral candidiasis is the most prevalent fungal infection of the oral cavity and is frequently associated with immunosuppression. Although traditionally classified as a superficial condition, growing evidence suggests that oral infection with Candida sp. in a susceptible host may disseminate and evolve into invasive candidiasis, such as bloodstream infection (candidemia), one of the leading nosocomial infections associated with high mortality. This review addresses the clinical manifestations of oral candidiasis, local and systemic risk factors, and the emerging role of non-albicans Candida and related yeasts in the pathogenesis of both candidiasis and candidemia. Furthermore, we revisit antifungal resistance, the interaction between Candida albicans and the oral microbiome, and the potential impact of these interactions on progression to invasive infection. Animal models of oral candidiasis and candidemia are also considered, highlighting their relevance for understanding virulence mechanisms and for developing new therapeutic strategies. In an integrative way, this review summarizes current evidence on the relationship between oral candidiasis and candidemia, emphasizing the importance of early diagnosis, prevention, and the search for alternative therapies in light of antifungal resistance.