Candidiasis

What is Candidiasis?

  • Candidiasis is a result of a fungal infection that occurs when there is an overgrowth of fungus called Candida.
  • Candidiasis is also known as a “yeast infection”.
  • Candidaisis is found on skin or mucous membranes.
  • Candidaisis always present in the body in small amounts.
  • However, when an imbalance occurs the organism can multiply.
  • It also can cause problems if it enters the bloodstream and spreads throughout the body.
  • There are 3 classifications of Candidiasis.

Oropharyngeal Candidiasis, Esophageal Candidiasis (OPC)

What is OPC?

OPC is candidiasis of the mouth and throat.  If the environment inside the mouth or throat becomes imbalanced, the Candida will multiply.  Candida overgrowth can also develop in the esophagus, and is called Candida esophagitis, or esophageal candidiasis.

Who is most at risk for OPC?

  • Normal newborns
  • People with dentures
  • People who use inhaled corticosteroids (used for symptoms of asthma)
  • It occurs more frequently in persons with weakened immune systems i.e.
    • People with AIDS
    • People undergoing cancer treatment
  • In healthy individuals this condition is unusual

How do I get OPC?

Most cases of OPC are caused by a person’s own Candida organisms which normally live in the mouth or digestive tract.  When an overgrowth of the organism occurs the onset of symptoms generally follow.

What are the symptoms of OPC?

  • Some people with an OPC infections have white patches in the mouth that are usually painless
  • Others may have redness and soreness inside the mouth
  • Cracking at the corners of the mouth may occur
  • Symptoms of Candida esophagitis may include pain and difficulty swallowing
  • Other conditions can cause similar symptoms making it important to see Dr. Cleaver to avoid other complications

How will Dr. Cleaver diagnose OPC?

OPC is usually diagnosed based on the clinical appearance of the mouth and by taking a scraping of the white patch and looking at if under a microscope.  Because the Candida organism is a normal inhabitant of the human body a culture of the mouth alone is not enough to make a diagnosis.

How can I treat OPC?

  • Prescription treatments include clotramazole lozenges and nystatatin suspension
    (“swish and swallow”)
  • Oral fluconazole works by killing the fungus or yeast, or preventing its growth
  • If the infection does not respond to these treatments, a number of other antifungal drugs are available through Dr. Cleaver

Is there anything else I should know?

  • If you do not seek treatment, symptoms may persist making you uncomfortable and in rare cases invasive candidiasis may occur
  • OPC and Candida esophagitis can become resistant to antifungal treatment over time so it is important to see Dr. Cleaver for an evaluation if you thing you have OPC or Candida esophagitis

Genital/ Volvovaginal Candidiasis (VVC)

What is genital candidiasis/VCC?

  • VCC is candidiasis of the vagina most commonly known by many women as a yeast infection
  • When the normal acidity of the vagina changes or when the hormonal balance changes the Candida can multiply
  • In rare cases, Candida can be passed from person to person, such as through sexual intercourse
  • There are some conditions that may predispose a woman to genital candidiasis:
    • Pregnancy
    • Diabetes mellitus
    • Use of broad- spectrum antibiotics
    • Use of corticosteroid medications

What are the symptoms of genital candidiasis/VCC?

  • Women with VVC usually experience genital itching or burning
  • A “cottage cheese-like” vaginal discharge may occur as well
  • Males with genital candidiasis may experience an itchy rash on the penis

How is genital candidiasis/VVC diagnosed?

  • 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 examining it under a microscope to see if Candida organisms are present

How is genital candidiasis/VVC treated?

  • There are several antifungal drugs available to treat genital candidiasis/VVC, most commonly used are vaginal suppositories and creams ranging from a single dose to 7 day doses.
  • Uncomplicated VVC may also be treated with single-dose or oral fluconazole (this should be avoided in pregnancy).
  • Short course treatment should be avoided in recurrent or resistant infections

Are the over-the-counter (OTC) treatments available?

  • Over- the- counter treatments(OTC) are available
    • Because of OTC drugs more women are diagnosing themselves with VVC and using one of many family drugs called “axoles” for therapy
    • However, the risk of misdiagnosis is common and 2/3 of all OTC drugs to treat  VVC were used by women without the disease
    • Using drugs when they are not needed may lead to a resistant infection, which are very difficult to treat with the currently available medications for VVC

To be safe if you think you have genital candidiasis/VVC talk to Dr. Cleaver about the treatment that is best for you!

Is there anything else I should know?

  • If you do not seek treatment your symptoms may persist which can be very uncomfortable. There is also a risk that you can pass the infection between sex partners
  • Because VVC and urinary tract infections share similar symptoms, such as burning sensations while urinating, it is important to see Dr. Cleaver and obtain laboratory testing to get a correct diagnosis and treat it effectively
  • Nearly 75% of all adult women have had at least one genital “yeast infection” in their lifetime
  • Men may also experience genital candidiasis but it is rare
  • VCC occurs more frequently and more severely in people with a weakened immune system. 

Invasive Candidiasis (VVC)

What is invasive candidiasis?

  • Invasive candidiasis is a fungal infection that occurs when the Candida organism enters the blood, causing a bloodstream infection and then spreading throughout the body
  • Invasive candidiasis is extremely rare in persons without risk factors
  • In people at risk for invasive candidiasis, an infection may result when the person’s own Candida organisms, normally found in the digestive tract, enter the bloodstream
  • In rare occasions, an infection can occur when medical equipment or devices become contaminated with Candida
  • In either case, the infection may spread throughout the body

How common is invasive candidiasis?

  • One form of invasive candidiasis, candidemia is the fourth most common bloodstream infection among hospitalized patients in the United States.
  • People at high risk for candidemia are:
    • Very low birth weight babies
    • Surgical patients
    • Hospitalized patients with a central venous catheter
    • People with a weakened immune system

What are the symptoms of invasive candidiasis?

  • 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.  These symptoms will vary depending on the site of infection
  • If the infection does not respond to treatment, the patient can suffer organ failure and death

How is invasive candidiasis diagnosed?

  • Invasive candidiasis is usually diagnosed by either culture of blood or tissue or by examining samples of infected tissue under the microscope

How is invasive candidiasis treated?

  • There are a number of antifungal drugs available to treat invasive candidiasis
  • Fluconazole can be taken by mouth or given intravenously (IV)
  • Echinocandins are also commonly used to treat invasive candidiasis
    • There are 3 types, all of which are given through an IV
    • All of these are effective in treating invasive candidiasis

All information gathered from http://www.cdc.gov/nczved/dfbmd/disease_listing/candidiasis_gi.html#11