Candidiasis, also known as "Candida infection", "yeast infection" or "thrush" is a common infection caused by strains of Candida fungi.
Candida fungi normally live harmlessly in the body, but under certain conditions (such as a compromised immune system) they can proliferate and cause disease.
Candida infection can occur in several different parts of the body, such as the mouth, vagina or skin.
Candida infection is treated with antifungal medications.
Certain measures, such as keeping the skin clean and dry, can help prevent candida infection.
Advertisement
What is candidiasis?
Candidiasis, also known as "Candida" or "yeast", is an infection caused by strains of Candida fungi, especially Candida albicans. Candida normally lives harmlessly in the body, but under certain conditions (such as an immune system compromised by HIV/Aids), they can multiply out of control. Candida can cause localised infections or overwhelming illness, depending on a person's general state of health.
Candidiasis affecting the mouth, vagina or moist skin folds is a very common early sign of immune system weakening from HIV disease. These infections, which may recur, most often first appear when the CD4 cell count drops to between 500/ul and 200/ul. Candida infection of the oesophagus (gullet) usually occurs with more advanced HIV disease.
Symptoms and signs of candidiasis
Candida infection is named according to the area of the body in which it occurs, and produces different symptoms, depending on the type of tissue infected. For example:
Oral thrush: "Thrush" is the common name for Candida infection of the mouth. It is characterised by white, usually painless patches inside the mouth, especially on the tongue and roof of the mouth, and around the lips. If the whitish surface of a patch is rubbed off, a red, inflamed area, which may bleed slightly, is exposed. There may be a bad taste in the mouth. The corners of the mouth may also be cracked and sore, and the fungus can cause creamy-yellow, raised sores. Oral thrush is generally not contagious.
Oesophageal thrush (oesophagitis): Oral thrush can spread to the oesophagus. This may make swallowing difficult or painful, and sometimes causes chest pain.
Cutaneous (skin) candidiasis: Candida can infect areas of skin that are moist and poorly ventilated. Common sites include the webs of fingers and toes, groin and crease of the buttocks, skin under the breasts, fingernail beds, and armpits. Cutaneous candidiasis causes patches of itchy (sometimes painful) red or darkened, weepy skin with small bumps or pustules. Other symptoms include peeling skin and swollen nail folds above the cuticle.
Vaginal yeast infection (candida vaginitis): commonly occurs as a result of self-contamination with yeast organisms from the rectum. Vaginal candida infections are not usually transmitted sexually, although this is possible. If the vulva (area around the entrance to the vagina) is also infected, the condition is called vulvovaginal candidiasis. Symptoms of vaginal yeast infection include:
Vaginal itching and/or soreness.
A white discharge that may resemble cottage cheese.
Burning discomfort around the vaginal opening, especially during urination.
Discomfort during sexual intercourse.
Redness and swelling of the vulva.
Balanitis: candida infection of the glans (head) of the penis and foreskin results in
red patches, swelling and blisters, sometimes with itching and burning.
Systemic candidiasis: Candida fungi contaminate the bloodstream and spread throughout the body, causing severe and sometimes life-threatening infection. Organs typically affected include the brain, eye, liver and heart. There may be a wide range of symptoms, from fever to shock and organ failure.
People with severely compromised immune systems can die from a form of blood poisoning known as candida septicaemia.
Sometimes a candida infection is present without symptoms.
How is candidiasis diagnosed?
Thrush, cutaneous candidiasis or vaginal yeast infection can often be diagnosed by its physical appearance, and examining a skin scraping or vaginal discharge sample through a microscope. If the diagnosis is in question, the doctor may send the sample to the laboratory for testing.
To diagnose oesophageal thrush, the doctor uses an endoscope, a flexible instrument that is passed into the oesophagus to allow direct examination of the area. During this procedure, called endoscopy, a sample is taken from the oesophagus for examination.
How is candidiasis treated?
Treatment of candidiasis makes use of antifungal drugs to curb the growth of the organism that causes the infection.
Oral thrush is usually treated with topical (applied directly to the affected area) antifungal medications such as nystatin or clotrimazole. For mild cases, a suspension of nystatin can be swished in the mouth and swallowed, or a clotrimazole lozenge can be dissolved in the mouth. For more severe cases, itraconazole or fluconazole may be taken - these are systemic antifungals, meaning they are absorbed through the intestine and reach the target via the bloodstream. If these medications are unavailable, a home remedy is one percent solution of Gentian violet painted twice daily inside and around the mouth (or vagina in the case of vaginal infection).
Oesophageal thrush is usually treated with pills such as itraconazole, fluconazole or ketoconazole, or it may require getting medicine injected (intravenously).
Cutaneous candidiasis can be effectively treated with antifungal powders, lotions and creams. The affected area must be kept clean and dry, and protected from chafing.
Vaginal yeast infections are treated with antifungal medications administered directly into the vagina as creams, ointments or suppositories. These medications include nystatin and so-called imidazole derivatives (clotrimazole, econazole, fenticonazole, ketoconazole, tioconazole, terconazole and miconazole.) Patients with recurrent infections are often treated with systemic antifungals. While taking antifungal medications:
Complete the full treatment even if the symptoms have gone.
Continue the course of treatment if you are menstruating.
Do not douche.
Avoid sexual intercourse when there is active infection.
Try applying a cold compress, such as a wash cloth, to the labial area several times a day to ease discomfort. Ask your doctor or pharmacist to recommend an anti-itch medication.
After urinating, wipe gently to avoid irritation.
Eat plain yoghurt with live cultures. It may help restore the normal bacteria of the gut and vagina.
Balanitis: In addition to practising good hygiene, antifungal medications may be required to clear the infection. If the problem recurs, adult circumcision may be an option.
Systemic candidiasis requires intravenous treatment at a hospital, usually with Amphotericin B. Cases of systemic candidiasis that are diagnosed quickly and treated effectively have the best outcome, especially if the infection can be stopped before it spreads to major organs.
In earlier stages of HIV infection when the immune system is still strong, candidiasis will generally not recur after treatment is stopped. However, as HIV disease progresses, recurrences of candidiasis are more common. It may be possible to control recurrent Candida infection by keeping a topical medication at home and using it whenever symptoms develop. However, some people may need to use medicine daily to prevent recurrences. Systemic treatment of candidiasis, usually with fluconazole, is recommended if topical medication does not effectively treat the infection or control recurrences.
How can I help prevent candidiasis?
You can help prevent candida infections by:
Keeping the skin clean, cool and dry.
Avoiding frequent or prolonged use of oral antibiotics if possible.
Losing weight if obese.
Keeping blood sugar levels as normal as possible if suffering from diabetes.
Wearing rubber gloves if your work involves keeping your hands in water for long periods.
Wash and dry your hands each time the gloves are removed. Applying a mild, over-the-counter antifungal cream may be of additional benefit.
To help prevent vaginal yeast infections:
The skin of the vulva and anus should be washed regularly and kept dry after bathing. Other people's towels or washcloths should not be used.
Avoid using chemical products such as bubble bath, hygiene spray, irritating soaps, perfumes or talcum powder.
Dry cotton or silk underclothes allow better airing and evaporation of excess moisture, compared to synthetics. Avoid tight-fitting garments, particularly during exercise.
Avoid vaginal douching. The vagina does not require cleansing other than normal bathing. Repetitive douching disrupts the balance of normal organisms in the vagina and can increase the risk of vaginal infection.
Although uncommon, candida organisms can be transmitted through kissing and orogenital contact.
Bookmark with:
What are social bookmarks?