Snapshot A 7-year-old presents to the pediatrician with a “white tongue.” On physical exam, he has notable thrush in his oral mucosa. His past medical history includes chronic diaper rash as a baby. It is otherwise unremarkable. Physical exam shows malformed nails on two fingers, consistent with onychomycosis. Labs are within normal limits. He is started on fluconazole. Introduction Primary immunodeficiency from dysfunction of T-cells Recurrent infections with noninvasive Candida albicans May also be susceptible to other bacterial and viral infections Genetics login to view 2 more bullets Pathogenesis login to view 2 more bullets Associated conditions login to view 2 more bullets Presentation Symptoms due to C. albicans infection of the following login to view 5 more bullets Evaluation All patients should be evaluated for other immunodeficiencies login to view 2 more bullets Absent in vitro response of T-cells to Candida antigen Absent cutaneous reaction to Candida antigen Genetic testing for mutations Differential Diagnosis SCID Immunodeficiency caused by HIV Treatment Chronic therapy with fluconazole Prognosis, Prevention, and Complications Prognosis login to view 1 more bullet Complications login to view 2 more bullets