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List of All Topics
Yeast Infections
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Introduction
Oropharyngeal candidiasis
Oral Thrush
Invasive candidiasis
Genital candidiasis
Deep candidiasis
Prevention
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
Antifungal medicines eliminate yeast infections in most people. If you have a weak immune system, treatment might be more difficult.
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.
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.
People with OPC infection usually have painless, white patches in the mouth. Symptoms of OPC in the esophagus may include pain and difficulty swallowing.
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. OPC is diagnosed in two ways. A doctor may take a swab or sample of infected tissue and look at it under a microscope. If there is evidence of Candida infection, the sample will be cultured to confirm the diagnosis.
Prescription treatments such as, Oral fluconazole, clotrimazole troches, or nystatin suspension usually provide effective treatment for OPC. Symptoms, which may be uncomfortable, may persist. In rare cases, invasive candidiasis may occur. Overuse of 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 from before treating with over-the-counter or other antifungal medications.
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Oral Thrush in Children
Most infants naturally have the yeast candida albican in their mouths. Because their immune systems are not yet mature, the amount of yeast in the mouth can overgrow and lead to an infection. (Adults and older kids who have weakened immune systems because of an illness or something like chemotherapy also can get oral thrush.) Oral thrush usually occurs within the first 6 months of life, and a baby with the infection will develop cracked skin in the corners of the mouth, and whitish or yellowish patches on the lips, tongue, or inside the cheeks.
There's not much that you can do to prevent your infant from getting oral thrush. Most cases go away without medical treatment within a week or two, but your child's doctor may prescribe an antifungal solution for the baby to swallow. And depending on your baby's age, the doctor may also suggest adding yogurt with lactobacilli to your child's diet. The lactobacilli are bacteria that can help eliminate the yeast in your child's mouth.
You can help remedy oral thrush if your child has it. If you are formula-feeding your baby or using a pacifier, it's important to thoroughly clean the nipples and pacifiers in hot water after each use. That way, if there's yeast on the bottle nipple or pacifier, your baby doesn't continue to get reinfected.
If you are breastfeeding and your nipples are red and sore, there's a chance you may have a yeast infection on your nipples, and that you and the baby are passing it back and forth. If so, you may want to talk to the doctor about using an antifungal ointment on your nipples while the baby is being treated with the antifungal solution.
If your child keeps getting oral thrush, or is older than 9 months and is getting oral thrush, talk with your child's doctor because this might be an indication of another health issue.
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Invasive candidiasis
Invasive candidiasis is a fungal infection that occurs when Candida species enter the blood, causing bloodstream infection and then spreading throughout the body.
One form of invasive candidiasis, candidemia, is the fourth most common bloodstream infection among hospitalized patients in the United States.. A survey conducted at CDC found that candidemia occurs in 8 of every 100,000 persons per year. Persons at high risk for candidemia include low-birth-weight babies, surgical patients, and those whose immune systems are deficient.
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.
Invasive candidiasis may result when a person’s own Candida organisms, normally found in the digestive tract, enter the bloodstream. On rare occasions, it can also occur when medical equipment or devices become contaminated with Candida. In either case, the infection may spread throughout the body.
Invasive candidiasis is usually diagnosed by either culture of blood or tissue or by examining samples of infected tissue under the microscope. Invasive candidiasis is usually treated with Amphotericin B given intravenously(IV) (in the vein) or with azole drugs taken by mouth or IV.
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Genital candidiasis
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.
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.
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:
- Pregnancy
- Diabetes mellitus
- Use of broad-spectrum antibiotics
- Use of corticosteroid medications
The symptoms of genital candidiasis are similar to those of many other genital infections. Making a diagnosis usually requires laboratory testing of a genital swab taken from the affected area by a physician.
Antifungal drugs which are taken orally, applied directly to the affected area, or used vaginally are the drugs of choice for vaginal yeast infections. Although these drugs usually work to cure the infection (80%-90% success rate), infections that do not respond to treatment are becoming more common, especially in HIV-infected women receiving long-term antifungal therapy. Prolonged and frequent use of these treatments can lessen their effectiveness.
The only difference between these is the length of treatment. Three-day and 7-day treatments may both be effective.
Over-the-counter treatments for VVC are becoming more available. As a result more women are diagnosing themselves with VVC and using one of a family of drugs called "azoles" for therapy. However, misdiagnosis is common, and studies have shown that as many as two-thirds of all OTC drugs sold to treat VVC were used by women without the disease. Using these drugs when they are not needed may lead to a resistant infection. Resistant infections are very difficult to treat with the currently available medications for VVC.
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.
Symptoms, which may be very uncomfortable, may persist. There is a chance that the infection may be passed between sex partners. Because VVC and urinary tract infections share similar symptoms, such as a burning sensation when urinating, it is important to see a doctor and obtain laboratory testing to determine the cause of the symptoms and to treat effectively.
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Deep candidiasis
In deep candidiasis, Candida fungi contaminate the bloodstream and spread throughout the body, causing severe infection. This is especially common in newborns with very low birth weights and in people with severely weakened immune systems or severe medical problems. In these people, Candida fungi may get into the bloodstream through skin catheters, tracheostomy sites, ventilation tubing, or surgical wounds. Deep candidiasis also can occur in healthy people if Candida fungi enter the blood through intravenous drug abuse, severe burns or wounds caused by trauma.
When Candida spreads to the bloodstream, it may cause a wide range of symptoms, from unexplained fever to shock and multiple organ failure.
To diagnose deep candidiasis, your doctor will draw a sample of blood to be checked in a laboratory for the growth of Candida fungi or other infectious agents. This infection is usually treated with intravenous amphotericin B (Abelcet) or fluconazole.
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Prognosis
Typically, in otherwise healthy people with superficial candidiasis, a properly treated infection goes away without leaving permanent damage. Candidiasis is unlikely to return as long as the person remains healthy and well nourished. In people with chronic illnesses or weakened immune systems, episodes of candidiasis may be more resistant to treatment and may return after treatment ends. In people with deep candidiasis, those who are diagnosed quickly and treated effectively have the best prognosis, especially if their infection can be stopped before it spreads to major organs.
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Information obtained from National Institute of Health