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Candidiasis - Causes, Symptoms and Treatment
Definition of Candidiasis:
Candida species are ubiquitous fungi found throughout the world as normal body flora. Unfortunately, candidiasis is also the most common mycotic infection, causing a variety of diseases. Candidiasis can range from superficial disorders such as diaper rash to invasive, rapidly fatal infections in immunocompromised hosts. Candidiasis, commonly called yeast infection or thrush, is a fungal infection of any of the Candida species, of which Candida albicans is probably the most common.
Causes of Candidiasis
Most cases of Candida infection result from C. albieans. Other infective strains include C. parapsilosis, C. tropiealis, and C. krusei. At least three quarters of all women will experience candidiasis at some point in their lives. The fungi responsible for candidiasis are part of the normal flora of the GI tract, mouth, vagina, and skin. Symptoms develop only when Candida becomes overgrown in these sites. Rarely, Candida can be passed from person to person, such as through sexual intercourse.
They cause infection when some change in the body permits their sudden proliferation - rising glucose levels from diabetes mellitus; lowered resistance from a disease (such as cancer), an immunosuppressive drug, radiation, aging, or human immunodeficiency virus (HIV) infection; elevated estrogen levels during pregnancy; or when they're introduced systemically by I.V. or urinary catheters, drug abuse, hyperalimentation, or surgery.
Symptoms of Candidiasis
Candidiasis can range abruptly in severity. It may be very mild and can go unnoticed, or there may be very pain in the mouth, especially on swallowing solid foods, or in the vagina in women or under the foreskin in men. It can also cause distortions in taste.
Superficial candidiasis produces symptoms that correspond to the following sites of infection:
1) Skin: scaly, erythematous, papular rash, sometimes covered with exudate, appearing below the breast, between the fingers, and at the axillae, groin, and umbilicus; in diaper rash, papules appear at the edges of the rash.
2) Nails: red, swollen, darkened nail bed; occasionally, purulent discharge and the separation of a pruritic nail from the nail bed.
3) Oropharyngeal Mucosa (Thrush): Thrush causes curdlike white patches inside the mouth, especially on the tongue and palate and around the lips. They may swell, causing respiratory distress in infants. They're only occasionally painful but cause a burning sensation in the throats and mouths of adult.
4) Esophageal Mucosa: In this symptoms seen are: dysphagia, retrosternal pain, regurgitation and, occasionally, scales in the mouth and throat.
5) Vaginal Mucosa: Vaginal yeast infections may cause the following symptoms: white or yellow discharge, with pruritus and local excoriation; vaginal itch and/or soreness; white or gray raised patches on vaginal walls, with local inflammation; dyspareunia; a burning discomfort around the vaginal opening, especially if urine touches the area.
6) Deep candidiasis - When Candida spreads to the bloodstream, it may cause a wide range of symptoms, from unexplained fever to shock and multiple organ failure.
Treatment of Candidiasis
The first aim of treatment is to improve the underlying condition that predisposes the patient to candidiasis, such as controlling diabetes or discontinuing antibiotic therapy and catheterization, if possible.
Treatments can be local or systemic. Local treatments are applied where the infection is found. Systemic treatments affect the whole body. Many health care providers prefer to use local treatment first. It puts the medication directly where it is needed. But in may give some side effects than a systemic treatment.
Some other treatment options are:
- Nystatin is an effective antifungal for superficial candidiasis.
- Clotrimazole, fluconazole, ketoconazole, and miconazole are effective in mucous-membrane and vaginal Candida infections. Out of these, Ketoconazole or fluconazole is the treatment of choice for chronic candidiasis of the mucous membranes.
- Treatment for systemic infection may consist of I.V. fluconazole or I.V. amphotericin B with or without 5fluorocytosine.
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