Candidiasis
Candidiasis is a fungal infection due to any
type of Candida (a type of yeast). When it affects the mouth, it is commonly
called thrush. Signs and symptoms include white patches on the tongue or other
areas of the mouth and throat. Other symptoms may include soreness and problems
swallowing. When it affects the vagina, it is commonly called a yeast
infection. Signs and symptoms include genital itching, burning, and sometimes a
white "cottage cheese-like" discharge from the vagina. Less commonly
the penis may be affected, resulting in itchiness. Very rarely, the infection
may become invasive, spreading to other parts of the body. This may result in
fevers along with other symptoms depending on the parts involved.
Symptoms and Complications
A
candida infection of the skin appears as a clearly
defined patch of red, itchy skin, often leaking fluid. Scabs and pustules may
be seen around the edge of the rash. It will usually be found in areas such as
the groin, the folds of the buttocks, between the breasts, toes, or fingers,
and in the navel. It may be hard to see on people with darker skin. A vaginal
yeast infection may well result in a slow leakage of a thick, white, clumpy
(cottage-cheese-like) substance with no or minimal odour.
The vagina may itch or burn, especially during urination or sex. Pain or
discomfort during intercourse is common. Candidal paronychia is candidiasis of the
fingernails. It often strikes people whose hands are in water a lot. Sometimes
it presents as a painful, red, swollen area around the fingernail. In worse
cases, the fingernail may separate, revealing a discoloured
white or yellow nail bed.
Oral
thrush causes curd-like white patches inside the mouth, on the tongue and
palate and around the lips. It may also cause cracked, red, moist areas of skin
at the corners of the mouth. Thrush patches may or may not be painful. Yeast
infections of the penis are rare but may cause the tip to be red, swollen, and
painful.
Cause
Candida
yeasts are generally present in healthy humans, frequently part of the human
body's normal oral and intestinal flora, and particularly on the skin; however,
their growth is normally limited by the human immune system and by competition
of other microorganisms, such as bacteria occupying the same locations in the
human body.[34] Candida requires moisture for growth, notably on the skin.[35]
For example, wearing wet swimwear for long periods of time is believed to be a
risk factor.[36] In extreme cases, superficial infections of the skin or mucous
membranes may enter into the bloodstream and cause systemic Candida infections.
Factors
that increase the risk of candidiasis include
HIV/AIDS, mononucleosis, cancer treatments, steroids, stress, antibiotic usage,
diabetes, and nutrient deficiency. Hormone replacement therapy and infertility
treatments may also be predisposing factors.
Treatment with antibiotics can lead to eliminating the yeast's natural
competitors for resources in the oral and intestinal flora; thereby increasing
the severity of the condition. A weakened or undeveloped immune system or
metabolic illnesses are significant predisposing factors of candidiasis.
Almost 15% of people with weakened immune systems develop a systemic illness
caused by Candida species. Diets high in simple carbohydrates have been found
to affect rates of oral candidiases. C. albicans was isolated from the vaginas of 19% of apparently
healthy women, i.e., those who experienced few or no symptoms of infection.
External use of detergents or douches or internal disturbances (hormonal or
physiological) can perturb the normal vaginal flora, consisting of lactic acid
bacteria, such as lactobacilli, and result in an overgrowth of Candida cells,
causing symptoms of infection, such as local inflammation. Pregnancy and the use
of oral contraceptives have been reported as risk factors. Diabetes mellitus and the use of antibiotics
are also linked to increased rates of yeast infections. In penile candidiasis, the causes include sexual intercourse with an
infected individual, low immunity, antibiotics, and diabetes. Male genital
yeast infections are less common, but a yeast infection on the penis caused
from direct contact via sexual intercourse with an infected partner is not
uncommon.
Diagnosis
Examination and sometimes culture
of a sample of infected tissue.
Many candidal infections are apparent from the
symptoms alone. To confirm the diagnosis, a doctor must identify the fungi in a
sample viewed under a microscope. Samples of blood or other infected tissues
may be sent to a laboratory to be cultured and examined to identify the fungi.
If candidemia is diagnosed, doctors may examine the
eyes to determine whether the eyes are infected.
Treatment
Candidiasis isn't normally a dangerous
disease except in rare cases when it enters the blood and spreads to vital
organs of people with weakened immune systems. For infection of the skin, your
doctor can give you an antifungal cream or powder or prescribe you an
antifungal pill. For vaginal yeast infections, treatment consists of antifungal
medications that are administered directly into the vagina as tablets, creams,
ointments, or suppositories, or administered by mouth (e.g., fluconazole*). For oral thrush, a suspension of antifungal
medication can be swished in the mouth and swallowed. For severe cases,
antifungal medication taken by mouth for several days may be needed. Speak with
your pharmacist - you can buy many of the creams and powder products intended
for minor infections without a prescription.
Prevention
A
diet that supports the immune system and is not high in simple carbohydrates
contributes to a healthy balance of the oral and intestinal flora. While yeast
infections are associated with diabetes, the level of blood sugar control may
not affect the risk. Wearing cotton underwear may help to reduce the risk of
developing skin and vaginal yeast infections, along with not wearing wet
clothes for long periods of time. Oral hygiene can help prevent oral candidiasis when people have a weakened immune system. For
people undergoing cancer treatment, chlorhexidine
mouthwash can prevent or reduce thrush. People who use inhaled corticosteroids
can reduce the risk of developing oral candidiasis by
rinsing the mouth with water or mouthwash after using the inhaler. For women
who experience recurrent yeast infections, there is limited evidence that oral
or intravaginal probiotics
help to prevent future infections. This includes either as pills or as yogurt.