Candidiasis
Candida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in your body. Usually, your immune system keeps yeast under control. If you are sick or taking antibiotics, it can multiply and cause an infection.
Yeast infections affect different parts of the body in different ways:
- Thrush is a yeast infection that causes white patches in your mouth
- Esophagitis is thrush that spreads to your esophagus, the tube that takes food from your mouth to your stomach. Esophagitis can make it hard or painful to swallow
- Women can get vaginal yeast infections, causing itchiness, pain and discharge
- Yeast infections of the skin cause itching and rashes
- Yeast infections in your bloodstream can be life-threatening
Oropharyngeal Candidiasis:
Candidiasis of the mouth and throat, also known as a "thrush" or oropharyngeal candidiasis (OPC), is a fungal infection that occurs when there is overgrowth of fungus called Candida. Candida is normally found on skin or mucous membranes. However, if the environment inside the mouth or throat becomes imbalanced, Candida can multiply. When this happens, symptoms of thrush appear. Candida overgrowth can also develop in the esophagus, and is called Candida esophagitis, or esophageal candidiasis.
OPC can affect normal newborns, persons with dentures, and people who use inhaled corticosteroids. It occurs more frequently and more severely in people with weakened immune systems, particularly in persons with AIDS and people undergoing treatment for cancer. Candida esophagitis usually occurs in people with weakened immune systems. It is very unusual in otherwise healthy people.
Most cases of OPC are caused by the person’s own Candida organisms which normally live in the mouth or digestive tract. A person has symptoms when overgrowth of Candida organisms occurs.
Symptoms: People with OPC infection usually have painless, white patches in the mouth. Others may have redness and soreness of the inside of the mouth. Cracking at the corners of the mouth, known as angular cheilitis, may occur. Symptoms of Candida esophagitis may include pain and difficulty swallowing. Other conditions can cause similar symptoms, so it is important to see your doctor.
Diagnosis: OPC is often diagnosed based on the clinical appearance of the mouth and by taking a scraping of the white patches and looking at it under a microscope. A culture may also be performed. Because Candida organisms are normal inhabitants of the human mouth, a positive culture by itself does not make the diagnosis.
Treatment: Prescription treatments include clotrimazole troches or lozenges and nystatin suspension (nystatin “swish and swallow”). Another commonly prescribed treatment is oral fluconazole. For infection which does not respond to these treatments, there are a number of other antifungal drugs that are available.
OPC and Candida esophagitis can become resistant to antifungal treatment over time. Therefore, it is important to see your doctor for evaluation if you think you have OPC or Candida esophagitis.
Genital/Volvovaginal Candidiasis (VVC): Candidiasis, also known as a "yeast infection" or VVC, is a common fungal infection that occurs when there is overgrowth of the fungus called Candida. Candida is always present in the body in small amounts. However, when an imbalance occurs, such as when the normal acidity of the vagina changes or when hormonal balance changes, Candida can multiply. When that happens, symptoms of candidiasis appear.
Symptoms: Women with VVC usually experience genital itching or burning, with or without a "cottage cheese-like" vaginal discharge. Males with genital candidiasis may experience an itchy rash on the penis.
Transmittion: Nearly 75% of all adult women have had at least one genital "yeast infection" in their lifetime. On rare occasions, men may also experience genital candidiasis. VVC occurs more frequently and more severely in people with weakened immune systems. There are some other conditions that may put a woman at risk for genital candidiasis:
·[FONT="] [/FONT]Pregnancy
·[FONT="] [/FONT]Diabetes mellitus
·[FONT="] [/FONT]Use of broad-spectrum antibiotics
·[FONT="] [/FONT]Use of corticosteroid medications
Diagnosis: The symptoms of genital candidiasis are similar to those of many other genital infections. Usually the diagnosis is made by taking a sample of the vaginal secretions and looking at it under a microscope to see if Candida organisms are present.
Treatment: Several antifungal drugs are available to treat genital candidiasis/VVC. Antifungal vaginal suppositories or creams are commonly used. The duration of the treatment course of suppositories and creams ranges from single dose therapy to 7 days of therapy. Uncomplicated VVC may also be treated with single-dose, oral fluconazole. Oral fluconazole should be avoided in pregnancy. These drugs usually work to cure the infection (80%-90% success rate), but some people will have recurrent or resistant infections. Short-course treatments should be avoided in recurrent or resistant infection.
Overuse of these antifungal medications can increase the chance that they will eventually not work (the fungus develops resistance to medications). Therefore, it is important to be sure of the diagnosis before treating with over-the-counter or other antifungal medications.
Invasive Candidiasis (VVC
Invasive candidiasis is a fungal infection that occurs when Candida species enter the blood, causing bloodstream infection and then spreading throughout the body.Symptoms: The symptoms of invasive candidiasis are not specific. Fever and chills that do not improve after antibiotic therapy are the most common symptoms. If the infection spreads to deep organs such as kidneys, liver, bones, muscles, joints, spleen, or eyes, additional specific symptoms may develop, which vary depending on the site of infection. If the infection does not respond to treatment, the patient’s organs may fail and cause death.
Diagnosis: Invasive candidiasis is usually diagnosed by either culture of blood or tissue or by examining samples of infected tissue under the microscope.
Treatment: There are a number of antifungal drugs that are now available to treat invasive candidiasis. Fluconazole is a drug that can be taken by mouth or given intravenously (IV) to treat invasive candidiasis. Another class of antifungal drugs, the echinocandins, are also commonly used to treat invasive candidiasis. There are three echinocandins, all IV only: caspofungin, micafungin, and anidulafungin. All threse are effective in treating invasive candidiasis. Other drugs that are sometimes used to treat invasive candidiasis include voriconazole (by mouth or IV) and amphotericin B formulations (IV only).